When it comes to processing claims, accuracy is essential. Using the wrong codes or codes that are too general could delay the claims process and result in less profit. Increase your pediatric practice’s collections by staying up-to-date with the latest CPT codes and modifiers.

Pediatric CPT Code Ranges for 2022

The following codes are the latest for pediatric CPT codes in 2022:

• 99381 – new patient preventative care for infant
• 99382 – new patient preventative care for 1-4 years old
• 99383 – new patient preventative care for 5-11 years old
• 99384 – new patient preventative care for 12-17 years old
• 99385 – new patient preventative care for 18+ years old
• 99391 – established patient preventative care for infant
• 99392 – established preventative care for 1-4 years old
• 99393 – established preventative care for 5-11 years old
• 99394 – established preventative care for 12-17 years old
• 99395 – established preventative care for 18+ years old
• 99401 – 15 minute counseling for preventative medicine or risk reduction
• 99402 – 30 minute counseling for preventative medicine or risk reduction
• 99403 – 45 minute counseling for preventative medicine or risk reduction
• 99404 – 60 minute counseling for preventative medicine or risk reduction
• 99411 – 30 minute counseling for preventative medicine or risk reduction for a group
• 99411 – 60 minute counseling for preventative medicine or risk reduction for a group
• 99211 – office visit that doesn’t require a qualified health professional
• 99491 – chronic care management, first 30 minutes
• 99437 – chronic care management, each additional 30 minutes
• 99487 – complex chronic care management, first 30 minutes
• 99489 – complex chronic care management, each additional 30 minutes
• 99424 – principal care management for a high-risk disease, first 30 minutes
• 99425 – principal care management for a high-risk disease, each additional 30 minutes
• 99426 – principal care management for a high-risk disease, first 30 minutes
• 99427 – principal care management for a high-risk disease, each additional 30 minutes

Pediatric CPT Modifiers

The following CPT modifiers are for pediatric care in 2022:

• Z00.110 – newborn under 8 days old health supervision
• Z00.111 – newborn between 8 and 28 days old health supervision
• Z00.121 – routine health exam for a child with abnormal findings
• Z00.129 – routine health exam for a child with no abnormal findings
• Z00.00 – routine health exam for an adult with no abnormal findings
• Z00.01 – routine health exam for an adult with abnormal findings
• Z28.3 – underimmunized status
• Z71.3 – dietary counseling or surveillance
• Z71.82 – exercise counseling
• Z71.84 – health counseling for travel purposes
• Z71.85 – counseling for immunization safety
• Z71.89 – other counseling, specified
• Z71.9 – other counseling, unspecified

Outsourcing your medical billing process is one way to maximize your pediatric practice’s collections. Additional benefits of outsourcing include reduced billing errors and a faster claims processing time.

Reason #1

Shorter A/R Time

A reduced A/R time is one benefit of outsourcing your billing processes. This is because a professional billing service is more experienced and efficient at making claims, speeding up the process significantly.

Reason #2

Fewer Billing Errors

Making mistakes in your billing can be costly. Not only could you miss out on collections because a claim wasn’t processed correctly but you could also get flagged for an audit due to suspected fraud. Hiring professional billers to handle your claims process for you can reduce this risk significantly.

Reason #3

Reduced Overhead Costs

Typically, when your billing is done in-house, you’ll need to have an employee who is able to dedicate themselves to that task. This means hiring more employees so that other administrative tasks can be taken care of as well as billing. If you outsource instead, you can save money by not having to hire as many staff members.

Reason #4

You’ll Have More Time for Patients

As a pediatrician, you’ll want to have as much time for your patients as possible. If you don’t have to handle your own billing in-house, then you can free up more time for more patients. This can also help to increase your practice’s profits because you’ll have more claims to process.

The Advantages of Outsourcing Your Medical Billing

There are many reasons why outsourcing your claims process can be beneficial for your pediatric practice. You’ll reduce the risk of having costly errors occur and you’ll save money on overhead costs. You’ll also free up more of your own time for more patients and can receive collections sooner.

Each of Quest National Services’ clients has unique needs and we, therefore, tailor our billing services for each client individually. On top of that, our professional billers are experienced and have the latest knowledge of CPT codes and modifiers and billing rules so that they can maximize your collections. Contact us today for more information.

Increasing your dermatology practice’s collections is the best way to keep everything running smoothly. Follow these tips to not only improve your medical billing but also to free up more of your time for additional patients.

#1

Make Time for More Patients

The best way to make more money is to see more patients. The more patients and the more patient visits you have, the more claims you can process. However, there’s only so much time in a day. If you’re having to process your all claims yourself, then it can be difficult to actually make time for more patients. However, if you combine this tip with one of the following two, you’ll be able to increase your collections.

#2

Streamline Your In-House Medical Billing

If you’re wanting to handle the entire billing process within your own practice, it’s a good idea to streamline the process. Assign claims processing to one employee, who can become an expert in the correct CPT codes and modifiers as well as stay up-to-date on billing rules. Having just one person submit claims can also mean that they’re done more quickly because that employee can prioritize them over other tasks.

#3

Hire a Medical Billing Service

Alternatively, you could outsource your medical billing to a professional billing service like Quest National Services. This can be the best solution if you don’t have enough staff or would prefer to hire fewer staff members. You won’t have to worry about freeing up time for processing claims. Instead, professional billers will handle that for you so that you and your staff can focus more on patients.

No dermatology practice could stay open for long without medical billing. However, it’s essential to process claims the right way or you could be missing out on revenue that could help your practice. The following are common errors made in the billing process that could negatively affect your collections.

Error #1

Your Codes Are Inaccurate

It’s essential to use the correct CPT codes in billing. If you don’t, the claim will be rejected by the insurance company. On top of that, if you make this mistake multiple times, you could end up getting audited for suspected insurance fraud.

Error #2

Your Codes Are Too General

Another common mistake is filing with CPT codes that aren’t specific enough. You could collect more revenue just by using modifiers for your CPT codes to be even more accurate.

Error #3

You Don’t File Claims in a Timely Manner

Medical practices of all kinds are busy. It’s understandable that it can take some time for claims to be filed. However, this could result in lost profit because many insurance companies have deadlines and if you don’t file in time, they could deny the claim.

Error #4

You’re Not Verifying Insurance Frequently Enough

Another common error is failing to verify insurance. Patients change their insurance companies all the time. If you don’t check, the patient might not think to update you, especially if the change happened a while ago and they haven’t had an appointment in that time. Not verifying insurance could result in billing the wrong insurance company, which could cause you to miss out on collections.

Error #5

You’re Underbilling Your Patients

When you process your billing in-house, people who aren’t experts in billing have to process claims. This could result in your staff underbilling your patients and their insurance companies.

Maximize Your Practice’s Profits with Outsourcing

One way to avoid the above errors and maximize your practice’s profits is to outsource your billing. A professional billing service will be trained in all of the latest billing rules and codes and they’ll have the expertise to file correctly and on time. On top of that, you’ll be able to take on more patients because you won’t have to spend as much time processing claims.

One way to maximize your dermatology practice’s profits is to outsource the billing process. Outsourcing has the additional benefits of reducing errors and increasing the speed at which collections are processed.

#1

Reduced Billing Errors

Billing mistakes can be extremely costly. Not only could you be missing out on collections, but you could also be flagged for fraud investigation if you frequently use incorrect codes. Outsourcing the claims process to a professional can ensure that errors in billing are reduced, improving your practice’s collections.

#2

Lower Overhead Costs

Every medical practice, including dermatology, has overhead costs. The more employees you need, the higher those costs will rise. By outsourcing your claims and billing, you can actually reduce your overhead costs because you won’t have to hire employees to handle it.

#3

Reduced A/R Time

Another benefit of outsourcing is reduced A/R time. Professional medical billers are faster and more effective at billing, which can help your practice to receive collections much more quickly than if you processed claims yourself.

#4

Increased Time with Patients

The biggest advantage of outsourcing your billing is that your own time is freed up. You don’t have to spend your time handling claims or figuring out which code to use. Instead, you can devote more of your working time to your patients. You can even take on new patients with the time you’ve freed up, which can result in increased collections for your practice.

The Benefits of Outsourcing Medical Claims

Dermatology practices can benefit from outsourcing for a number of reasons. On top of freeing up more of your own time for seeing existing and new patients, you also reduce the risk of costly mistakes and can receive collections faster.

Quest National Services knows that each of its clients has unique needs and tailors its billing services to cater to each individual client. Additionally, our expert billers have the latest knowledge about codes, modifiers, and billing rules. Don’t hesitate to contact us for more information.

Accurate medical billing is essential to the running of any practice, including those in the pediatric field of medicine. The following errors are common ones that practices make in their billing that can reduce potential collections.

Error #1

Inaccurate Codes

A common mistake that occurs during the billing process is using the wrong codes. This can be problematic not only because the insurance company may reject the claim but also because too many inaccurate codes could get you flagged for an audit to check that you aren’t committing insurance fraud.

Error #2

Codes That Are Too General

Accurate coding isn’t the only criterion for maximizing your collections. Codes also need to be specific. If you’re too general with your coding, you might be leaving money on the table. You might be able to collect more if you’re able to use more specific codes and modifiers.

Error #3

Filing Claims Late

Insurance companies may have time limits on how long you can wait to file a claim and still collect. Filing claims late is a common error because doctors are busy with patients. However, missing the deadline could result in also missing out on collections.

Error #4

Underbilling Patients

If you’re underbilling your patients, you’re not making as much as you could. Underbilling can occur when staff members aren’t properly trained on medical billing rules and codes.

Error #5

Not Verifying Insurance Frequently Enough

Billing the wrong insurance company can cause claims to be rejected and could result in you missing the deadline with the correct insurance company. It’s essential to check with patients every time they come in that their insurance information is accurate.

Outsourcing Your Medical Billing Can Eliminate Mistakes

One way to eliminate billing errors is to outsource your claims filing process. Professional medical billers will be more familiar with accurate and specific codes and are dedicated to billing, so claims are always filed on time.

The best way to ensure that your pediatric practice can treat as many patients as possible is to increase your collections. Follow these tips to maximize your practice’s profits.

Tip #1

See More Patients

The more patients you have, the more claims you can process, which, in turn, can bring in more collections for your practice. However, pediatricians are already busy and may not have the time to add more patients. Following the rest of these tips will help you to free up that time.

Tip #2

Outsource Your Medical Billing

One option for taking the billing process off your hands is to outsource it. Hiring a professional billing service can not only free up your time but also ensure more accurate claims.

Tip #3

Streamline Your In-House Claims Process

Not everyone is comfortable outsourcing their billing process and prefers to keep it in-house instead. If you’d rather manage your own claims, you can still streamline them to free up time. The best way to do this is to dedicate a staff member or two to the billing process. That way, they can become experts in the codes and regulations required.