Pediatrics Billing Services

Are your pediatric billing duties spilling over to your frontline caregivers? Inefficient handling of billing causes claims denials and delays. You need expert help to minimize your billing administrative burden. Our specialized HIPAA-compliant pediatric billing services offer the solution to navigate pediatric billing requirements while focusing on your core tasks.


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How We Streamline Pediatric Billing for Your Practice

Our CPEDC-certified coders understand the complex nature of pediatric codes and their correct usage. They have acquired this mastery by meeting the billing and coding needs of general pediatric clinics, specialty pediatric centers (e.g., pediatric cardiology, oncology), urgent care pediatric hospitals, and school-based health clinics, among others. You can bank on them to leverage their expertise to reduce claims denials, enhance cash flow, and revamp your pediatric billing process end-to-end. Here is how we help you with our pediatric billing and coding services:

  • Integrate digital tools like electronic medical records (EMRs), electronic health records (EHRs), electronic data interchange (EDI), and other capabilities into the new or existing pediatric billing software to facilitate electronic claims processing and handle electronic payments.
  • Gather all patient information, including demographics, medical history, and physician referrals, and verify comprehensive insurance details such as insurance coverage, prior authorization status, effective dates, expiration dates, and claims address to generate accurate claims documentation.
  • Check if pre-authorization is required for any rendered services and apply for approval if needed.
  • Expertise in handling diverse pediatric billing models, including value-based billing, capitation billing, telehealth billing, and school-based billing.
  • Assign accurate codes for age-specific and new/established patient codes (e.g., 99204/99205), ICD-10-CM, and HCPCS codes (like E1229-E1239 for pediatric wheelchairs) for rendered pediatric services.
  • Adhere to the latest coding parameters while billing for pediatric services, including neonatology, behavioral psychology, gastroenterology, pulmonology, diabetes, oncology, neurology, vaccinations, and others.
  • Align with any revisions in fee schedules or payment guidelines for diverse insurance payers such as Medicare Medicaid, the Children's Health Insurance Program (CHIP), FEHBP, etc., as well as private insurers like UnitedHealth, Cigna, and Humana, among others.
  • Examine the Explanation of Benefits (EOBs) from the payers to identify any payment discrepancies, resolve them, and proceed with the appeals process accordingly.
  • Follow up with insurance payers to verify patient benefits and obtain a comprehensive understanding of deductibles, copayments, and coinsurance for each patient. Inform patients about their payment responsibilities to reduce unpaid claims for patients.

Our Comprehensive Pediatrics Billing Outsourcing Services

  • Patient registration
  • Insurance verification
  • Medical coding and billing
  • Claims submission and follow-up
  • Accounts receivable (A/R) management
  • Payment posting and reconciliation
  • Patient billing and collections
  • Compliance monitoring
  • Reporting and analysis

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Request a Free 15-minute Consultation with Our Pediatric Billing Specialists Today!

During the consultation, some of the issues we can discuss are:

  • Your current pediatric billing workflow, challenges, and inefficiencies. 
  • How we ensure coding and billing accuracy to gain maximum reimbursement
  • How we stay updated on changes in pediatric billing regulations and requirements such as HIPAA, CMS, and more.
  • Our success stories in billing and claims submissions for various critical pediatric services.

Step-by-step process for Pediatrics Billing Services
Step-by-step process for Pediatrics Billing Services

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Why Choose Our Pediatric Billing Services?

As a seasoned pediatrics medical billing services provider with over 24 years of experience, we have tailored our billing services to meet the requirements of a diverse clientele. The list includes general pediatric hospitals, children's hospitals, specialty pediatric centers, pediatric ICUs, emergency pediatric centers, and more. Our team of certified billers (CPB) and coders (CPC), supported by credentialing experts, claims processors, accounts receivable (AR) specialists, and compliance officers, help our clients streamline their billing process effectively. We have a successful track record of assisting our clients to achieve a clean claims rate of 98% and an improvement in net collection rate of 95%. Additionally, we have made a denial benchmark below 8% and an average days in AR of about 35-40 days.


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What Our Customers Say

We have been working with Invensis for the past two years, and they have helped us overcome many revenue cycle management challenges. The team often walks the extra mile to ensure that our needs are met.

Christina Sussex
Leading Healthcare Provider in France

Invensis has been our revenue cycle management healthcare outsourcing partner for the past 5 years. They have always delivered on their commitments, whether it is meeting our Service Level Agreement (SLA) or improving our billing process.

Christopher Middleton
Leading Healthcare Company in US

Invensis has been a great partner providing quality medical coding and billing services. The team is extremely responsive to every query we pose, and the turn-around time for deliverables is always as committed.

Chris Lauren
Leading Healthcare Company in US

What Our Customers Say

We are thrilled with the impeccable chiropractic billing services offered by Invensis. Their comprehensive knowledge of the industry, prompt claims processing, and meticulous attention to detail have immensely benefited our healthcare reimbursements. Highly commendable!

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John Davis
Leading Healthcare Company in the UK.

We are extremely pleased with the exceptional hospital billing services provided by Invensis. Their expertise and attention to detail in Medicare billing and compliance in medical billing have streamlined our revenue cycle and improved financial performance.

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Emily Johnson
Leading Hospital in the US.

Invensis has been an invaluable partner for our organization, providing exceptional ASC billing services. Their expertise and dedication have significantly improved our revenue cycle management. Highly recommended!

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Sarah Smith
Leading Healthcare Provider in Italy.

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Contact Information

You can reach us at:

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+1 (302)-261-9036
Locate Us
Invensis Inc. 2785 Rockbrook Dr STE 204 Lewisville, TX 75067

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