Pediatric
Implement a streamlined pediatric billing process and maximize reimbursement with QB’s solutions.
Pediatric billing can be complex due to the wide range of services pediatricians provide, from infancy through young adulthood. Pediatricians handle various conditions, treatments, procedures, and preventative care, making pediatric billing and coding a specialized field. With the changing regulatory environment, managing pediatric medical billing in-house is increasingly difficult. To improve patient engagement and strengthen financial outcomes, many providers choose to outsource their pediatric revenue cycle management.
At QB, we bring specialized expertise and resources to simplify pediatric revenue cycle management. Our solutions reduce administrative burdens, giving providers more time to focus on patient care while improving financial results.
Our Pediatric Revenue Cycle Management Services
Eligibility Verification & Prior Authorization
We verify pediatric service eligibility, secure prior referrals/authorizations when needed, and calculate deductible and co-payment amounts.
Pediatric Billing
We handle accurate and timely claims submission, ensuring compliance with ever-changing guidelines, leading to high collection rates.
Pediatric Coding
Our expert coding team translates clinical documentation into precise ICD-10 codes, CPT codes, and applies the necessary modifiers to ensure proper reimbursement.
A/R & Denial Management
Our accounts receivable and denial management services reduce A/R days, effectively manage denials, and promptly resubmit corrected claims, improving cash flow.
Pediatric Billing Expertise
We provide comprehensive billing services for a wide variety of pediatric specialties, including:
- Adolescent Medicine
- Behavioral Psychology
- Child Life Program
- Clinical Genetics
- Neonatology
- Pediatric Cardiology
- Pediatric Diabetes
- Pediatric Endocrinology
- Pediatric Gastroenterology
- Pediatric Infectious Diseases
- Pediatric Nephrology
- Pediatric Neurology
- Pediatric Oncology
- Pediatric Orthopedics
- Pediatric Pathology
- Pediatric Pulmonology
- Pediatric Surgery
QB Insights
Pediatric revenue cycle management begins at patient registration and continues until appropriate reimbursement is received for services rendered. Each step in the process is crucial, and mistakes in pediatric billing and coding can lead to claim rejections, denials, and increased compliance risks. Based on our extensive experience, we’ve identified some of the most common pediatric billing errors.
Incomplete Patient Information
Missing or incomplete patient details can delay claims and lead to denials.
No Prior Authorization
Failure to obtain prior authorization when needed can result in claim rejections.
Inaccurate Pediatric Coding
Incorrect coding leads to reimbursement delays and compliance issues.
Use of Wrong Modifiers
Misapplied modifiers can cause claims to be rejected or underpaid.
Overlooked Vaccine Billing
Failing to properly bill for vaccinations can lead to missed revenue.
These issues are preventable, and correcting them can significantly improve reimbursement. With QB’s expertise in pediatric medical billing, we ensure accuracy at every step, resulting in fewer denials and enhanced financial performance. Let us help you optimize your pediatric billing process and achieve the best possible financial outcomes.