pediatric practice management

It's official - go sign up.  Space is limited.  Similar to our previous endeavors but two days, a lot of content, and the largest collection of pediatric practices in one place all year long.  The best part -it's at Disney, you bring your family! 

It's also substantially cheaper than other events held at the same location (or elsewhere) around the same time...

I am, again, in the back of the room at our Coding and Practice management event and listening to Dr. Tuck. I have to steal a line or two from him, he’s got some good ones. Dr. Lander is next.

I’ve noticed some real changes in the audiences I speak to over the last few years. Today, when I ask, “Who uses RVUs to set prices?” most of the hands go up. Even 2-3 years ago, almost none went up. I like that.

I am doing some research into the most common pediatric codes in order to set up a spread/worksheet for use during an insurane negotiation.  Lots of “consultants” routinely make the mistake of suggesting that you look at your top 10 or, more daringly, top 20 or 30 codes when comparing reimbursement between two plans.

That’s stupid  Flat out stupid.

Long overdue, but I did try to get them right. Thanks go out to Donelle Holle as well as Igor and Q who helped check them out before posting.

If you'd like a nice, neat copy, you can download the PDF. I was going to post the entire thing here, but it is much too long. Here is a sample Q/A:

1. What RVU is associated with 99058 (emergency)? Do insurers pay?

The 99058 CPT code has no RVUs. There are, indeed, many insurers that pay the office emergency code however. Of course, payment will vary from one carrier to another – payments are usually between $20 and $75. When using this code, remember to document the fact that the service was indeed an emergency, as we all know that not all walk-ins are emergencies.

Don't forget that we have another AAP-endorsed event scheduled for September!

Whew, we have finally gotten our ducks in a row and announce our Fall Pediatric Coding and PM conference in Columbus, OH on September 17. It's the usual deal: AAP endorsed and AAP members get in cheaper. The individual class titles include:

• Free Online Practice Management Tools
• Coding Primer
• Give Me the Money: How to Decrease your A/R
• The Codes You Leave on the Table
• Pediatric Physicians' Compensation Models
• Vaccine Coding: Preventive Medicine for a Healthy Bottom Line
• The No Surprises Chart Audit

Please check out the promotional site or register ASAP!

It's been tough getting to the blog the last week or so.

Igor and I have been working tirelessly on the various pediatric benchmarks we track for our customers (and the rest of the world). In fact, we've been focusing on developing a single PCC financial benchmark figure, with a clinical one to follow.

As a result of building this page, we have had to do a lot of thinking about normalization of scores, benchmark "ranges" and more. I thought I'd share a quick review of a tiny part of what we've seen so far. Here are three interesting changes in the values of key measurements from 2006 to 2007:

First, I like seeing that 7% drop in the median A/R days! It's particularly notable when we realize that even more PCC customers dropped capitation this year (bye bye, BCBS HMO of NJ).

Also interesting is the "Revenue Per Visit" data. For the first time ever, PCC clients have passed the magic $100/visit line - an increase of over 10% - good news. Great news, actually. Until you pull the immunizations out of it...and realize that nearly 80% of the increase our customers saw in their revenue last year got plowed straight back into the pharms. No wonder they have such bad reputations.

Still, no need to sneeze at a 3% increase in per-visit revenue when report after report shows things moving in the opposite direction.

Meanwhile, some of you may want to check out this blog/podcast, the Pediatric Pearls Show. In an ideal situation, I envision a practice getting a call from a mom about, say, wanting care for her kid with a cold, but not having the time to bring him on - perhaps the nurse could direct the mom to the episode about The Common Cold? Of course, you have to vet these for yourself, but it's an overdue idea.

I have a vision of being one of those fancy bloggers who somehow writes a "live" blog from some important event. I don't know why, but it seems cool.
So, as I type, Dr. Tuck is giving the first full lecture of the day, his CPT 101 course. Dr. Lander goes next with his "Give Me the Money" bit. My quick assessment of the crowd today:

• A lot of PCC clients! Good to see them.
• This crowd is famished for this information.

Our coding/PM event is filling up. I have to update the talk about Pediatric Compensation Models with more recent data, but otherwise we're in good shape. This will be great.

It's not too late to sign up, I'd love to see you there.

* April 17 Pediatric Coding Conference: Earn 5.0 CEUs!

This April 17, put your practice ahead of the curve with PCC's 2008 Spring Pediatric Coding and Practice Management Conference, endorsed by the American Academy of Pediatrics. Pediatric coding experts will address key issues in a full day of courses and question and answer sessions designed to improve your coding practices and reimbursement. PCC's 2008 Spring Pediatric Coding and Practice Management Conference will be held at the Capital Hilton in Washington, DC. This is an intensive, one-day session focused on important pediatric issues that effect your practice everyday. You'll master the coding basics, tackle additional coding topics, get answers to your specific questions during Q&A sessions with our pediatric panel, and gain valuable insight on timely pediatric issues!Our expert panel of instructors includes Richard Lander, MD, FAAP, Richard Tuck, MD, FAAP, and PCC's Chip Hart.

* Earn Continuing Education Units (CEU)

This program has prior approval of the American Academy of Professional Coders for 5.0 Continuing Education Units. Granting for prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

* Learn More and Register Now

View the complete course schedule and register online now at: www.pcc.com/practmgmt/codeconf0408.php Admission to this conference is only $325 for AAP members ($379 for non-members)! Space is limited, so register now.

I get a lot of little messages every day that I feel like I should save and/or share, but they don't add up to an entire blog entry (I don't like to do more than one a day, if that, as it feels like spamming). So, here's my house cleaning:

• The AAP has released the 2008 Immunization Schedule. You can read the details from Pediatrics here or get the PDF/chart here.
• Speaking of the Pediatrics journal, here's an interesting reprint about "Incorporating Quality Improvement Into Pediatric Practice." It's a few years old, but still rings true. I keep getting ideas about how to measure the value of preventive care, but I never follow through. For years, I just presumed the data was there, the connection being so obvious. What a surprise when I learned it hasn't been done! Someday.
• Here is an interesting site (thank you Dr. Stoller) that will give you a side-by-side summary of the health care positions and proposals for each of the presidential candidates who is still in race (I am disappointed that they drop those who have dropped out, as I'd still like to see their positions). Courtesy of the Kaiser Family Foundation.
• Thanks to SOAPM, I have this piece to share:
  

  In response to concerns raised by the AAP and several pediatricians across the country, UHC revised its clinical policy on palivizumab. Effective January 1, 2008, benefits coverage for palivizumab will now be aligned with the AAP recommendations published in the Red Book. UHC is in the process of sending notification letters to its physician provider network. A copy of the AAP letter to UHC can be accessed on the AAP Member Center, private payer advocacy page. Many thanks to SOAPM members for sharing information about the change.

  Thanks to The Verden Group for that text.

• Finally, Lynn@Eden sent out a heads-up to PedTalk about Merck pricing changes:
  

  Pricing up 4%, effective Mar 1, on Gardisil, MMR, Rotashield, Varivax
  Gardisil promo (if you purchase >70 doses) extended until Feb 29
  Time to negotiate with your inscos for an increase in reimbursement
  before you have to buy in at the higher price