Revenue Cycle Services for Neonatal Practices
Building a denial-free revenue cycle through billing & coding solutions customized for Neonatal care centers
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Neonatal Billing & Coding Services
Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn. It is a hospital-based specialty, usually delivered in neonatal intensive care units (NICUs). The principal patients of neonatologists are newborn infants who are ill or require special medical care due to:
Prematurity
Low birth weight
Intrauterine growth restriction
Congenital malformations or disabilities
Sepsis
Pulmonary hypoplasia
Birth asphyxia
A neonatologist is responsible for the life and healthy recovery of the smallest human beings who pose the most extensive & complicated challenges. Partnering or Outsourcing the management of your revenue cycle to an offshore company like MBW lessens the burden of streamlining the hospital's financial aspect.
Medical Billing & Coding Services Expertise in Neonatology
At MBW, we have a client base that spans across all 50 states, covers a wide range of hospitals with NICUs, physician practices, and medical billing companies. Our coders are proficient in ICD-9/10, CPT, HCPCS coding guidelines provided by CMS and AMA and certified by the American Academy of Professional Coders (AAPC). It would be fair to state that we have a decade of experience in neonatal billing & coding. We also specialize in LEVEL III NICU billing & coding.
Applying best practices for Neonatal Billing & Coding Services
We apply the correct codes for both E/M services offered to a healthy newborn vs. NICU codes for newborns with congenital disabilities. To avoid rejections & re-submissions from the clearinghouse, our team submits clean claims the first time itself and abides by the policies, rules & regulations of all payers. Our coding team employs its extensive knowledge and facilitates the proper use of modifiers to avoid denials.
Best practices for neonatal coding:
Physicians should include Newborn Care Services codes for evaluation and management (E/M) services provided to normal newborns in the first days of life before hospital discharge. Codes for initial care of the normal newborn include:
| 99460 | Initial hospital or birthing center care, per day, for E/M of a normal newborn infant |
| 99461 | Initial care per day, for E/M of normal newborn infant seen in other than hospital or birthing center |
| 99463 | Initial hospital or birthing center care, per day, for E/M of a normal newborn infant, admitted and discharged on the same date |
Codes 99478-99480 describe the intensive care provided to evaluate and manage the recovering low or very low birth weight infant. The code is selected based upon the present bodyweight of the infant as below:
| 99478 | Present bodyweight less than 1500 grams |
| 99479 | Present bodyweight of 1500-2500 grams |
| 99480 | Present bodyweight of 2501-5000 grams |
Inpatient Neonatal Critical Care
The initial day of critical care for evaluating and managing a critically ill neonate, 28-days of age or less is reported with code 99468. We report this code for only one physician. If another physician provides critical care services to the neonate on the same date, we report the services provided using critical care service codes 99291-99292.
Subsequent days of critical care to the critically ill neonate are reported per day with code 99469. As with the initial critical care, code 99469 is used to report only for one physician on a given date.
Exception Service Delivery leading to a Shift from Denial Management to Prevention
We bring excellence, knowledge, and accuracy in neonatal billing and coding services while building a revenue cycle devoid of defects for your hospital. 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. Medical Billing Wholesalers helps hospitals offer excellent care for their little patients, focusing on improving their administrative & financial excellence.
Benefits of our Neonatology Billing and Coding Services
We bring excellence, knowledge, and accuracy in neonatal billing and coding services while building a revenue cycle devoid of defects for your hospital. 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. Medical Billing Wholesalers helps hospitals offer excellent care for their little patients, focusing on improving their administrative & financial excellence.
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Ensuring accuracy and compliance in neonatal billing and coding, essential for minimizing errors in this complex field.
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Streamlining processes from billing to payment posting, crucial for healthy cash flow.
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Proficiently handling claims with major insurers like UHC, WellPoint, Aetna, Humana BCBS, and Anthem, as well as Medicare and Medicaid, demonstrating adaptability in a diverse insurance landscape.
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Actively managing prior authorizations and following up on receivables to reduce claim denials and improve financial outcomes.
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A team certified by the American Association of Professional Coders, with training in medical coding software, ensuring expertise in handling complex cases.
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Achieving a substantial cost reduction, up to 50-60%, by leveraging global delivery models, enhancing both clinical and operational efficiency.
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Typically seeing an improvement in revenue by 20% and a reduction in denials by at least 15%, indicating a direct positive impact on the financial health of the hospital.
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Elevate your hospital's neonatal billing and coding efficiency today. Contact us to harness these benefits and drive significant financial and operational improvements for your healthcare services.