Pediatrics

Pediatric billing is multifaceted. Why? It’s because pediatricians work with patients from infancy to young adulthood and provide a diverse and extensive range of services to deal with various conditions, treatments, procedures, and preventative healthcare. This is why pediatric billing and pediatric coding necessitate a unique set of skills to ensure proper reimbursement. In fact, with the evolving regulatory landscape, it is more difficult than ever to perform pediatric medical billing services in-house. With the need to improve patient engagement and strengthen the bottom line, providers turn to outsourcing to implement effective pediatric revenue cycle management strategies.

As a pediatric billing company, 3Gen Consulting has the specialized knowledge and resources required to streamline the pediatric revenue cycle management process, reduce providers’ administrative burden which provides them with more time to focus on their patients and ultimately improve financial outcomes.

Our Pediatric Revenue Cycle Management Services

  • Eligibility Verification & Prior Authorization
    Our team verifies pediatric service eligibility, obtains prior referrals/authorization (if necessary) and computes the deductible and/or co-payment amount.
  • Pediatric Coding
    Our pediatric coding service translates clinical documentation into accurate ICD-10 codes, CPT codes and assigns appropriate modifiers.
  • Pediatric Billing
    Our pediatric billing service ensures accurate and timely claim submission, compliance with changing guidelines, and high collection rates.
  • A/R & Denial Management
    Our pediatric accounts receivable and denial management solutions are intended to reduce A/R days, manage denials, and resubmit corrected claims to improve cash flow.
Urgent Care Billing

Pediatric Billing Expertise

  • Adolescent Medicine
  • Behavioral Psychology
  • Child Life Program
  • Clinical Genetics
  • Neonatology
  • Nutrition Services
  • 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

3Gen Insights

Pediatric revenue cycle management begins with patient registration and continues till the provider receives appropriate reimbursement for the services rendered. Every step is important, which means that unfortunately there are also many chances for pediatric billing and pediatric coding errors to occur during the process. These errors can result in claim rejections or denials and can also increase a provider’s compliance risk. Based on our experience, we have identified the below reasons as some of the most common pediatric billing and coding errors. It’s important to note that these errors are in fact preventable and can result in significant reimbursement improvement if the pediatric medical billing services process is corrected to avoid denials.

Incomplete Patient
Information

Incomplete Patient Information

No Prior
Authorization

Prior Authorization

Inaccurate Pediatric
Coding

Inaccurate Pediatric Coding

Use Of Wrong Modifiers

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Vaccine Billing Is Overlooked

Home Health and Hospice Billing Services
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