pediatric practice management

Billing of Influenza Vaccinations in a Pediatric Practice

September 27, 2012 in Uncategorized by support Team  |  Comments Off on Billing of Influenza Vaccinations in a Pediatric Practice

It is very typical for Pediatric practices to begin the process of vaccinating patients with the flu vaccines during September. Although most Pediatric practices maintain a protocol for medical billing related to giving flu vaccinations, it is a good idea to review the common billing practices.
Some questions to ask related to the influenza vaccine include: Will the physicians be examining the high risk patients as part of the flu vaccination process? Will the office set up a flu clinic for which either a Medical Assistant or Nurse administers the vaccine? Will the practice allow flu shots to be administered on weekends or after hours?
Below is the list of CPT as well as vaccination administration codes associated with influenza vaccination.
90655 Influenza virus vaccine, split virus, preservative-free, for children 6–35 months of age, for intramuscular use
90656 Influenza virus vaccine, split virus, preservative-free, when administered to 3 years of age and above, for intramuscular use
90657 Influenza virus vaccine, split virus, 6–35 months of age, for intramuscular use
90658 Influenza virus vaccine, split virus, 3 years and older, for intramuscular use
90660 Influenza virus vaccine, live, for intranasal use

Vaccine Administration Codes also need to be associated with Flu Vaccinations
If the patient is 18 years of age or younger and obtains vaccine counseling by the physician or other qualified health care professional Report CPT code 90460. If both of the criteria are not met (either over 18 years of age or does not obtain vaccine counseling by the provider), utilize the appropriate code from the 90471-90474 series. Utilize CPT Code 90471 if the influenza injection is given as the only vaccine or CPT Code 90473 if the intranasal form is the only provided vaccine. If the influenza vaccine is provided with other vaccines and the patient is either over 18 or the provider does not provide counseling, report 90472 for the influenza injection or 90474 if the intranasal form. Note that the appropriate diagnosis code for the flu vaccine is v04.8

How Aligned are your consultants to the Goals of Your Pediatric Practice?

July 10, 2012 in Uncategorized by support Team  |  Comments Off on How Aligned are your consultants to the Goals of Your Pediatric Practice?

A Pediatric practice needs to successfully work with both internal and external stakeholders to be successful. These stakeholders include employees and external vendors/companies and sometimes, consultants. There can be misalignment of the goals of each of these stakeholders with the goals of your Pediatric Practice. There are a number of questions to ask a consultant to insure they represent your best interests.

Some of these questions could include:
-Is the consultant recommending a product or service due to an alliance with their firm or due to quality of the product for your practice? For instance, a company that sells servers will have a bias to recommend server E.H.R. systems due to their revenue being made based on providing advice and maintaining servers. If a consultant speaks at an event sponsored by a Vendor, this might indicate that there is a bias for this vendor. A question to ask: Is the speaking engagement with a particular vendor due to the vendor providing them customers that they can charge their consultant service and do they speak equally at events for all vendors in the same state (not just the ones that send them practices)?
-Having a consultant choose an E.H.R. service, could cause a Pediatric office to obtain an ‘old’ technology product or a product that does not appropriately balance the revenue/cost needs of the practice with the desire for a consultant to provide a service. Some consultants might not have the technical expertise to make the ‘right’ decision for your Pediatric Practice. Recommend asking any “E.H.R. consultant” how long they have managed a practice as well as their experiences with optimizing revenue for a practice (there are many with great experiences and unfortunately some with none to minimal experience). Equal time should be spent discussing the revenue cycle/practice management as well as clinical aspects of the E.H.R.. Consulting advice should look to optimize revenue, minimize burden, cost and start-up time. The practice is ‘on the hook’ for long-term operation of a system/process and the receiving end of decisions made regarding a system.
-Does this consultant make more or less money if the practice identifies a solution that requires minimal work on their part? Why would a consultant that charges by the hour (whether paid for by the practice or the government) seek a system that reduces billable hours? The long-term operational burdens are the responsibilities of the practice not a consultant.

Exceptional consultants with a solid history should be able to balance the needs of their clients with the need to optimize their own billable hours. Great consultants know and understand the revenue cycle and provide hints on how to reduce administrative burdens of Pediatric Practices. With all the conflicting priorities and needs of a Pediatric Practice, it is important for a practice owner to select the ‘best’ consultants/advisors for their particular needs.

Continuity of Care in Pediatric Practices & the Link to Cloud-Based E.H.R. Systems

April 13, 2012 in Uncategorized by support Team  |  Comments Off on Continuity of Care in Pediatric Practices & the Link to Cloud-Based E.H.R. Systems

While at the pharmacy waiting for prescription Medication, I experienced the gap in knowledge by the average patient. One patient requested a medication to treat his wife’s pink eye from the pharmacist. When she explained that his wife will need an antibiotic he asked if he could use the antibiotic he was using to treat his ears. She explained to him that his wife needed a health care provider to exam her then based on the diagnosis, prescribe the appropriate medication for her red eyes. The husband was not coordinating care with his wife’s primary care physician.

Many in the health care system are missing the big picture when they do not call their primary care physician. In pediatrics, the outcome of the patient can be improved via strong continuity of care. If a patient is atopic and calls the office about a reaction to a medication, the pediatrician can use this information to appropriately manage the patient as well as record the incidence in the patient’s history. From the patient’s point of view, strong coordination with their pediatric office could reduce their burden and costs associated with using the Emergency Room. The pediatrician receives calls after office hours. The information available to the pediatrician should be able to be accessed easily at any time. Cloud-based Pediatric E.H.R. systems provide the best option for easy access to patient information on multiple devices in multiple locations…smart phones, IPads, lap tops, home computers. Who wants the burden of ‘dial in’ to the office server as well as maintaining constant security of the server?

As coordination of care continues to evolve as well as the option in wireless devices, Pediatricians can continue to reduce admin burden, costs and improve continuity of care with cloud-based E.H.R. Systems.