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Pediatric Billing & Coding Services

Pediatrics is the branch of medicine that diagnoses & treats diseases in infants, children & adolescents. Per the American Academy of Pediatrics, pediatric care refers to care provided for people up to 21. Pediatricians deal with numerous conditions, procedures, treatments, and preventive healthcare.

Pediatric billing & coding is different from other specialties as it requires the billers & coders to be aware of elements such as vaccines. Careful coding must be performed for vaccination records so that the practice gets paid appropriately. Pediatrics can be stressful due to its innumerable modifiers & bundling requirements.

The in-house staff in pediatric practices have more on their plates than other specialties, as dealing with children can be challenging. The front-office team should ensure a shorter waiting time since children are susceptible to contagious diseases and can be very restless. They also maintain vaccination records, age change documents, and government compliance policies. Specialized coding and billing personnel are needed to avoid compromising patient care and ensuring accuracy in processing.

Whatever be the size of your pediatric practice, outsourcing your billing & coding requirements to a seasoned pediatric billing service provider like RM Healthcare can help you save costs and infuse new energy into your revenue cycle. We offer prior authorizations, claim submission, accounts receivable, denials management, and credentialing Services. Our team of pediatric billing specialists can help build a leakage-free revenue cycle for your practice.

Pediatric Billing & Coding Services

Medical Billing & Coding Services Expertise in Pediatrics

At RM Healthcare, we have a client base that spans across all 50 states, covers a wide range of hospitals, physician practices (including pediatric practices), and medical billing companies. Our coders are proficient in ICD-9/10, CPT, HCPCS coding guidelines provided by CMS and AMA, and are certified by the American Academy of Professional Coders (AAPC). It would be fair to state that we have a decade of experience in pediatric billing & coding.

Applying best practices for Pediatric Billing & Coding Services

We ensure that the threshold tome for converting a superbill to a claim is minuscule. To avoid rejections & re-submissions from the clearinghouse, our team submits clean claims the first time itself and abides by policies, rules & regulations of all payers to prevent. We perform prior authorization and verify the benefits of the patient before the day of patient visits. Our coding team employs its extensive knowledge and facilitates the proper use of modifiers to avoid denials. Our expertise in Pediatrics includes but is not limited to:

  • General Pediatrics
  • Pediatric Endocrinology
  • Pediatric Diabetes
  • Pediatric Gastroenterology
  • Pediatric Cardiology
  • Pediatric Pulmonology
  • Pediatric Nephrology
  • Nutrition Services
  • Pediatric Infectious Diseases
  • Clinical Genetics
  • Behavioral Psychology
  • Pediatric Neurology
  • Pediatric Oncology
  • Child Life Program

Benefits of our Pediatric Billing and Coding Services :

We bring excellence, knowledge, and accuracy in pediatric billing and coding Services while building a revenue cycle devoid of defects for your practice. Our team strives to introduce a friction-free billing, coding, claim submission, and payment posting process. We ensure persistent accounts receivable follow-up and prior authorization to avoid claim denials. Our denials team focuses on shifting your focus from denial management to denial prevention. RM Healthcare helps pediatricians concentrate on offering excellent care for their little patients, focusing on improving their administrative & financial excellence. We bring you a team of specialists who are:

  • Certified by The American Association of Professional Coders (AAPC) and has received training in most common Medical Coding Software
  • Successful in processing medical claims with commercial insurance companies including UHC, WellPoint, Aetna, Humana BCBS, and Anthem, and government payers such as Medicare
  • Successful in working with Medicare and understand state-specific Medicaid Policies
  • Experts in reducing costs and helping you achieve improved clinical and operational efficiency

Our clients typically see an improvement in revenue by over 20% and a reduction in denials by a minimum of 15%. We achieve this by applying our expertise and process rigor.


RM Healthcare handles more than 250,000 patient support calls each month