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Pediatrics

We know your specialty, let us build your business.

Pediatrics is often riddled with complications when billing out charges for various encounter types.

The ongoing changes in the healthcare environment have necessitated that a billing team have dedicated and prompt follow through on denials and no claim responses. The range of patient care issues provided by Pediatrics is wide and varied. Even though our focus is on medical billing and accounts receivable management, our broad experience across the entire Revenue Cycle Management process in Pediatrics is why we can give you an advantage compared to in-house billing.

Our team at Etransmedia has the knowledge and skills necessary to successfully work denials and provide our Pediatrics clients with valuable feedback to assist in managing and decreasing the most frequently seen denial types, while streamlining revenue and increasing your practice’s collection rates. Getting you paid fast!

What we know…

A NEW patient is seen for a routine well child visit, age specific immunizations are given and a separately identifiable (sick visit) evaluation & management service is performed.  We know that the Preventative Medicine CPT codes for a new patient (99381-99385) should be used.  Since the patient is now considered an established patient to the practice you will need to use the established patient Evaluation & Management CPT codes (99212-99215) and not the new patient CPT codes (99201-99205) for the sick visit.  In order to have all three services (PM, sick visit, immunization) considered for payment, Modifier 25 must be appended to both the sick visit CPT code and the preventative medicine code.

 

Do you know what CPT code to use with your screening tools?

 

CPT codes  –   Abbreviation  –   Instrument

96110  –   ASQ  –   Ages and Stages Questionnaire – Third Edition

96127  –   ASQ:SE  –   Ages and Stages Questionnaire: Social-Emotional

96127  –   ASAS  –   Australian Scale for Asperger’s Syndrome

96127  –   BYI-II  –   Beck Youth Inventories – Second Edition

96127  –   BASC-2  –   Behavior Assessment Scale for Children – Second Edition

96127  –   BRIEF  –   Behavioral Rating Inventory of Executive Function

96127  –   (none)  –   Briggance Screens II

96127  –   BITSEA  –   Brief Infant and Toddler Social Emotional Assessment

96127  –   (none)  –   Connor’s Rating Scale

96110  –   (none)  –   Denver II

96127  –   (none)  –   Kutcher Adolescent Depression Scale

96110  –   M-CHAT  –   Modified Checklist for Autism in Toddlers

96127  –   PHQ-2 or PHQ-9  –   Patient Health Questionnaire

96110  –   PEDS  –   Parents’ Evaluation of Developmental Status

96127  –   PSC  –   Pediatric Symptom Checklist

96127  –   Y-PSC  –   Pediatric Symptom Checklist – Youth Report

96127  –   SCARED  –   Screen for Child Anxiety Related Disorders

96127  –   SDQ  –   Strength and Difficulties Questionnaire

96127  –   CRAFFT  –   Substance Abuse and Alcohol Abuse Screening

96127  –   (none)  –   Vanderbilt Rating Scales

 

On October 1, 2016 the Centers for Medicare and Medicaid Services (CMS) will no longer accept unspecified codes in most cases. 

Starting in October, CMS requires greater specificity for claims filed in ICD-10-CM/PCS. The 12-month grace period originally introduced in 2015 said they would not deny claims for lack of ICD-10 specificity. That all changes on October 1, 2016. Payors will most likely follow suit if they haven't already.

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First Pass Clean Claim Rate

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Boost in Revenue*

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Reduction in Cost*

Amazing Result

We’re always on top of all the latest coding and billing updates for Pediatric practices. Additionally, to make sure all claims are reimbursed on the first claim submission, our system is able to pre-edit claims prior to the initial submission for possible billing/coding errors. Our detailed end of month reports keep our clients up-to-date on what is happening in their practice so any issues can be addressed quickly. Having an experienced medical billing team, with visibility into performance, is vital to your practice’s financial health.

Although the new industry standards can be confusing and difficult to navigate, our dedicated team here at Etransmedia can assist in guiding you and helping to make your practice grow successfully.

*Please Note: Results are not guaranteed, implicitly or explicitly, and will vary based on several factors such as individual practice demographics, specialty, payer mix, operations, and management among others

Service and Technology Packages

Our customizable revenue cycle management service and technology solution packages allow you to outsource based on the specific needs of your practice

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Silver RCM Service

This package has the core service and technology needed for revenue management allowing you maintain the responsibility of patient billing.

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Gold RCM Service

This package includes the core RCM services with added denials, A/R management services, and full service patient billing

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Ancillary RCM Services & Technology

Available to enhance any package

MEDICAL BILLING SERVICES

Improve your revenue by letting our services handle your revenue cycle process

PRACTICE OPERATIONS

Full-featured solution packages customized to focus on what your practice needs

PHYSICIAN CREDENTIALING

Building, managing, updating, submitting, tracking, and verifying credentialing applications is a necessity

TECHNOLOGY SOLUTIONS

Connect2Care® is a turnkey solution that improves workflow and financial results.

The group at Etransmedia has handled my billing and managed my contracts for more than a decade. They are trustworthy … Read More >
- Stephen Lutz MD

President, Eastern Woods Radiation Oncology

When my former billing company decided to close abruptly, I contacted Etransmedia to help me set up my own business… Read More >
- Ann Aring, MD, FAAFP

Assoc Program Director, Riverside Family Practice Residency Program

Just a note to say ‘thanks’ – having Etransmedia handle the billing was one of the best decisions this Board has ever made … Read More >
- Paul Hardick

Cumberland Valley Counseling Associates

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