Pediatric Medical Billing Services

The typical pediatric medical practice of today handles a remarkably broad and diverse number of conditions, procedures, treatments, well-child care as well as preventative health care. Unlike most other medical specialties, a pediatric practice is not usually limited to a single body system, set of related conditions or type of procedure or treatment. Even if the young patient ultimately is referred to another specialist for further care, almost anything an infant, child, adolescent or young adult may present as a medical problem typically is evaluated first, and often treated or managed, by the Pediatric primary physician. The enormous diversity of diagnostic and treatment options results in challenges requiring a billing service that is up to the task of managing varied, interrelated and complicated coding and contractual issues seamlessly and efficiently and in a timely fashion.

Most pediatric medical practices often face health care coverage enrollment issues not frequently seen in adult-centered health care. Newborn infants transition from medical insurance coverage directly through their mothers to coverage based on their own contractual entitlement shortly after birth.  Unlike most adults, children typically receive their health care insurance coverage through one or both parents, setting up more claim or duplicate coverage issues best handled by an expert pediatric medical billing service. Occasionally, a pediatric practice may even wrestle with coverage emanating from the insurance policy of a third-party, such as a grandparent, when the parent of a covered child is still a dependent herself.

APS has carefully developed the sophistication and specialized knowledge to offer the pediatric practitioner superior pediatric medical billing services support. A proactive and extensive investment in state of the art billing technology allows APS to make sure its pediatric medical billing services provide clients prompt and effective methods to recover the greatest insurance reimbursement. We have developed processes described in the industry as "best practices" related to charge capture/reconciliation, claims submission and denial management.  An extensive series of front end edits result in cleaner claims and fewer re-files and/or appeals.

The industry-leading claims strategies used by APS to maximize positive billing outcomes will result in better returns for our Pediatric clients.  The systems used by APS return over 97% of claims filed on the first pass, resulting in a healthier accounts receivable picture for your pediatric medical practice.

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Services: Pediatric Medical Billing Services

• Complete revenue cycle management
• Coding
• Physician credentialing and re-credentialing

Supporting Functions

• Individualized Client Services
• Customized information reporting & performance monitoring