Wiki New to peds billing

dragonflye

Networker
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Location
Phoenix, AZ
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Hello. Just wondering if anyone has tips or advice on how to bill peds. There is a lot to fix here and its just the tip of the iceburg. I'll be learning family practice at the same time as well. We have emr which is great but a lot of my work will be the denials or claims that never got sent out. Thanks.

Katie
 
If you are working your age report I would start with your claims that have denied for COB (coordination of benefits) typically its UHC that will have the most claims being pended or denied for that reason. These can be fixed /processed easily by calling the member to let them know they have to update COB (sometimes 3 time a yr) in order for the claim to process. It is also usually the WCC that they are denying/pending. Then attack your NB claims. The fist few visits most likley have denied and you can check on availity for your Humana & BCBS and then the other ins websites to see if these claims are on file (they tend to "drop" them from the system). Refile these claims for the payors that won't dup them out, and drop to paper the ones that would (even thought they say NOF!! I have this issue with Humana)

Thats all I got! Good luck :)
 
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