There are numerous challenges associated with Pediatrics billing service because of its complex nature. It is essential for your billing and coding staff to be well-versed in terms, procedures, and services related to Pediatrics services.
Does the low cost of billing make you concerned about the elimination of multidisciplinary processes? Is your in-house billing staff unable to solve complicated billing issues? Are you dissatisfied with the performance of your billers and coders? Are you having trouble resolving your billing issues on time and losing revenue? If so, you should think about outsourcing your internal medical billing services to a reputable medical billing company to improve your cash flow.
How CompleteCare Medical Billing Can Help in Pediatrics Billing Services
CompleteCare medical billing company offers internal billing services to healthcare facilities all over the United States for many years. In order to maximize revenue, every Pediatrics practice needs effective, timely, and error-free billing and coding services. Our team of qualified, professional, and certified coders and billers assists our clients in providing accurate, timely, and error-free billing services for Pediatrics.
Pediatrics Medical Billing Services We Offer
As a medical billing company specializing in Pediatrics billing services, we understand the complexities and issues of submitting claims accurately and complying with all rules for sequencing, specificity, and granularity.
We provide complete billing services for Pediatrics that includes the following:
Patient Appointment Scheduling for Pediatrics Practice
For many healthcare providers, scheduling patients’ appointments is a challenging task, and they seek assistance with appointment scheduling. The practice staff is always very busy, so they do not have time to answer patient calls to schedule appointments, so they would lose patients, which would reduce revenue.
CompleteCare Medical Billing LLC provides healthcare providers with 24/7 patient appointment scheduling services. We will respond to patients’ phone calls within seconds of receiving them. Having a professional team of experts, we are fully capable of scheduling, confirming, and canceling the patient’s appointment.
Insurance Eligibility & Benefits Verification Service for Pediatrics Billing
It is essential for the healthcare providers to check the patient’s eligibility and benefits before the visit. The eligibility and benefits of the patient can change with their insurance at any time, so it is very important for healthcare providers to verify the patient’s insurance and eligibility on every visit to ensure the patient is active and the claim will be paid. If eligibility and benefits are not verified, there will be more rejections and denials, ultimately resulting in lower reimbursements.
We at CompleteCare Medical Billing have a team of experts working on eligibility and benefits verification. In addition, they verify the eligibility status of the patient with the insurance company and the benefits associated with Pediatrics services. As part of our verification process, we verify procedure coverage and benefits, as well as out-of-pocket costs so that patients know what they are responsible for upfront.
The process helps the healthcare providers to receive the amount in a timely manner, avoiding unnecessary delays in payments. In eligibility and benefits verification, we verify a variety of data, including:
- Effective date and coverage details
- Individual patient eligibility
- Type of plan
- Deductible, co-pay, and co-insurance
- Non-covered procedures
- Referrals & pre-authorizations
Demographic and Charge Entry Services for Pediatrics Billing
The charge entry process is one of the key components of medical billing. According to the coding and applicable fee schedule, created patient accounts are assigned with the respective $ value during the medical billing charge entry process. Physician’s services will be reimbursed based on the charges entered. CompleteCare Medical Billing has an experience in demographic and charges entry service. Our Pediatrics billing team can provide you with accurate and high-quality billing services that ensure patient demographic data is collected accurately.
AR Follow Up Service for Pediatrics Billing
The revenue of the practice is influenced by the accounts receivable team. An estimated 6-15% of claims need to be followed up in order to be reimbursed. There are times when you submit a claim to the insurance and do not receive payment from the insurance because of a variety of reasons such as incorrect patient information, coding errors, etc, and the accounts receivable department takes action on those cases that will improve the collection rate of the physicians.
It is very time-consuming and difficult to follow up on unpaid and denied claims. CompleteCare Medical Billing offers the services of AR follow-up on unpaid claims. We make sure to follow up on every unpaid claim until it is paid by insurance. Our receivables team works on each claim and resubmits it if it is denied or rejected, as well as sends the appeal, if necessary, in a timely manner so that the claim will be paid by the insurance company.
Denials and Rejections Management Services for Pediatrics Billing
Denials and rejections of claims are another reason for the low reimbursements for healthcare providers. Working on denials and rejected claims is an extremely important part of medical billing because if a claim is rejected or denied by the insurance, the medical billing company must understand and evaluate the reason for the rejection or denial, then take the right steps, make correction in the claim, and send the claim back to the insurance in a timely manner so that they receive payment from the insurance. Ultimately, failure to handle denials and rejected claims at the right time will result in the loss of reimbursements, so resolving the denials and rejected claims is essential to move the cash flow forward.
CompleteCare Medical Billing has a team of experts with knowledge and experience in handling denials and rejected claims. They are certified and equipped with the latest knowledge about medical billing, and they understand the guidelines of every insurance company.
In order to maximize reimbursement for healthcare providers, we make sure to resolve every denial and rejected claim within 48 hours after the claim was denied or rejected. Our Pediatrics billing experts and analysts will help you keep track of denials, analyze the reason for denials and rejections, and they will also help in reducing the number of denials.
Payment Posting Service for Pediatrics Billing
Cash posting, also known as payment posting, is a crucial step in the medical billing process. It indicates the financial strength of any practice. CompleteCare Medical Billing identifies the various reasons for denial at the time of payment posting, including medical necessity, not covered services, prior authorization not provided, etc., and assigns to the appropriate team.
A review of ERAs and scanned EOBs (Explanation of Benefits) is conducted to ensure that all details about the payment are recorded. There are times when a minor error in payment posting changes the overall picture of the practice’s financial position. That is why our team makes sure there are no errors in payment posting to ensure the practice has a realistic picture of its financial condition.
Credentialing and Enrollment Services for Pediatrics Billing
In medical billing, credentialing and enrollment are very important processes that ensure the providers are employable and that they can bill the insurance companies for their services. Providers may not submit claims if credentials have not been established with payers. Claims acceptance and processing depend on credentialing and enrollment.
Credentialing and enrollment with payers is a very tedious and time-consuming process. This process requires a lot of attention and care because a minor error in the enrollment and credentialing application can cause a week or month delay in the processing of the application, and may result in low reimbursement.
The mission of CompleteCare medical billing is to provide credible credentialing and enrollment services to Pediatrics practices. Prior to submitting the claims to the specific payer, our expert team ensures credentialing is completed successfully to avoid denials and maintain cash flow. By speeding up this process and ensuring that a provider is enrolled with every major payer, we are able to save you time and money.
Pediatrics Practice Audit
An audit of your practice is really necessary to ensure you are not losing money. There are no underpayments or coding errors associated with our claims payments. CompleteCare medical billing offers complete practice audits. CompleteCare Medical billing has a team of experts and professionals to offer a variety of services to their clients to help them achieve that goal.
Our practice audit includes the following
Revenue cycle Audit
- Coding analysis
- Revenue integrity program implementation
- Reimbursement reviews
- Denials management
- Appeals process optimization
- Charge description master (CDM) review
Coding & billing compliance audit
- Inpatient, outpatient & physician coding reviews
- Clinical documentation improvement (CDI)
- 2021 Evaluation & Management (E/M) Guidelines
- Incident-to & Split/shared
- Risk Adjustment & Hierarchical Condition Coding (HCC)
Why Choose CompleteCare Medical Billing for Pediatrics Billing
We ensure immediate reimbursement and maximize insurance reimbursements. With the Right medical billing, you will have a billing team dedicated to making sure you get every dollar you are entitled to. We become an extension of your practice when you partner with the Right medical billing. Our staff is well-versed in coding and billing. Getting paid for your services is not our only focus, but also reducing administrative costs and increasing your profitability.
If you are experiencing problems with denials and rejections, aging, delays in payment, etc., then CompleteCare Medical Billing is the best solution for you. Our team will handle every claim so you can spend more time with patients.
Right medical billing company has AAPC-certified medical coders and billers with current and in-depth knowledge of HIPPA and the revenue cycle. With our expertise in Pediatrics billing, private Pediatrics practitioners would be able to collect on time without the risk of being underpaid.
CompleteCare medical billing will help you to:
- Improve collections by up to 20%
- A nearly 98% clean claim rate
- Offers accurate and high-quality medical billing and coding services
- Constant evaluation of each account
- Continual review of diagnostic and procedural codes
- Reduction in denials and rejections
- Accelerate cash flow
- Reduce administrative costs
- Minimize medical billing rejections and denials
- Ensure billing compliance
We take care of every claim. Contact CompleteCare medical billing today and you will no longer have to worry about medical billing and coding issues. Having your billing handled by professionals will free up more time for you to spend on patients.