Finding new opportunities for pediatric billing is critical to maintaining the health of pediatric medical practices, and new legislation might be a change that aligns with the health of the children and families you care for. As you review the act, look for opportunities to expand pediatric medical billing and coding services.
Understanding the Helping Kids Cope Act
The Helping Kids Cope Act (H.R. 2412) is bipartisan legislation designed to support the pediatric mental health workforce and give kids better access to the full continuum of mental health care. It does this by establishing new grant programs at the Health Resources and Services Administration (HRSA) for urgent needs for pediatric mental and behavioral healthcare. The grants take on the task of [1]:
- Improving children’s access to support and community-based services. This happens through the strengthening of community-based pediatric mental health services, enabling pediatric care communities to implement and develop the new policies and programs that meet the unique mental and behavioral health needs of their patients.
- Expanding and enhancing the pediatric mental health workforce. Through the expansion of mental and behavioral health training, care communities will see an increased capacity of the current pediatric health workforce and support for recruitment and training of new pediatric mental health professionals.
- Investing in critical pediatric mental health infrastructure. When critical pediatric mental health infrastructures are expanded, the country will see improvement in the national capacity to deliver the best care possible for the children who have more intensive needs. These include inpatient psychiatric care, as well as step-down care like day programs and intensive outpatient services.
How Pediatric Providers Should Respond
Anyone responsible for pediatric medical billing and coding services should look at this as an opportunity.
Pediatricians are often the sole source of care for kids with mental health issues. This means that pediatricians are increasingly stepping up as mental health care providers. And pediatricians have been doing a good job. Research has found that when a pediatrician prescribed medication for a child who has depression or anxiety, it was generally done appropriately. But only one of out three children who were prescribed medication were also referred to a therapist [2].
This reveals that there is a gap in pediatric mental health care – and one that can be addressed by providers who are willing to expand the services they offer. These providers should consider this when looking for additional sources of revenue – the avenues opened up by the Helping Kids Cope Act mean the potential for new service lines and potentially the opportunity to leverage the help of pediatric medical billing companies to make sure your revenue cycle stays as healthy as possible.
Consider the idea that, if children are in a position where they warrant medication, they should also be receiving other services. Eric Butter, chief of psychology at Nationwide Children’s Hospital in Columbus, Ohio emphasizes the fact that children who are given medication should also be receiving some form of counseling, saying that “a pill never taught a kid how to cope better.” Only a minority of children appear to be referred to a therapist, largely because of the lack of mental health specialists available.
For pediatricians, this means an opportunity to consider offering billable services by bringing on providers such as psychologists, psychiatrists and other mental health care providers into their practices. Pediatricians have an amazing amount of leverage here in encouraging the use of any services they do decide to add on since families are leaning on them for guidance in navigating mental health issues.
How Pediatricians Can Move Forward
It’s important to understand the services you might be adding. Mental health issues are prevalent in patients under the age of 18 [3]:
- Over half of children have some type of disorder
- Almost 20% have a specific phobia
- Depression affects 18.6%
- 12.6% are diagnosed with oppositional defiant disorder
- ADHD affects 8.1%
Many pediatricians and pediatric trainees feel that they are not prepared to address these behavioral and mental health problems – which is exactly why expanding the services you offer and working with pediatric medical billing companies can be a win-win for your patients and your financial health.
Improving Pediatric Medical Billing and Coding Services
As awareness of the resources available to children spreads, expect to see parents pushing for more access to mental and behavioral healthcare.
There will be an increase in use of services from psychiatrists, psychologists, therapists, counselors and other types of mental health professionals, and you do not want to wait to figure out your strategy as things shift. Know that your parents will be asking questions about where they can access the best care for their children, and providers who offer these services within one practice will have a competitive advantage over other pediatricians. You should anticipate that some parents will be open to switching providers for the smoothest mental health experience possible for their children, giving preference to providers who offer more services in one practice.
This means now is the time to lay out the services you might want to offer and figure out how they could increase your cash flows. Keep in mind that bringing on any of these services can put extra pressure on your revenue cycle, which is why you should also be considering working with pediatric medical billing companies to ensure the smoothest possible transition for your staff and your patients.
If you are looking for options in pediatric medical billing companies, contact us today so we can help you formulate a revenue cycle strategy that aligns with your behavioral and mental health planning for the future.
References
[1] Children’s Hospital Association, “Bipartisan Legislation Would Invest in Children’s Mental Health Care and Workforce,” 24 May 2023. Available: https://www.childrenshospitals.org/content/public-policy/policy-position/helping-kids-cope-act.
[2] A. Norton, “For Kids With Mental Health Issues, Pediatricians Are Often Only Source for Care,” HealthDay, 17 April 2023. Available: https://www.usnews.com/news/health-news/articles/2023-04-17/for-kids-with-mental-health-issues-pediatricians-are-often-only-source-for-care#:~:text=%22Pediatricians%20can%20effectively%20identify%20mental,be%20therapists%2C%20Butter%20pointed%20out.
[3] The American Board of Pediatrics, “Behavioral and Mental Health,” 2023. Available: https://www.abp.org/foundation/behavioral-mental-health.
