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Running a small or large practice is just like running a small or large business. Private practice pediatricians need to have a good handle on the financial aspects of their practice in order to maintain a positive cash flow and stay in business. This section of Practice Management Online provides a wide array of resources related to the financial aspects of practice management, including the costs associating with starting and maintaining a practice, establishing effective contracts with third-party payers, billing and collections, management of debt, and other key topics.
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| 1. | 2009 RBRVS Conversion Spreadsheet (2009)
Committee on Coding and Nomenclature
This conversion spreadsheet is a "hands-on" tool for calculating 2009 Medicare payment rates for services in your geographic locality. Now that three-quarters of all public and private payers including State Medicaid programs have adopted components of Medicare RBRVS, pediatric practices need to be adept in making these conversions to stay healthy and strong.
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| 2. | 2009 RBRVS: What Is It and How Does It Affect Pediatrics? (2009)
Committee on Coding and Nomenclature
This brochure is a pediatrician's guide to Medicare's Resource-Based Relative Value Scale (RBRVS). It provides simple explanations of its elements (physician work, practice expense, professional liability expense), the Medicare global period, the geographic practice cost indices, and tells you why RBRVS matters to pediatricians.
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| 3. | Coding Calculator (2009)
American Academy of Pediatrics
This valuable tool allows you to calculate your Evaluation & Management (E/M) distribution according to a selected time period and several reporting trends. |
| 4. | Hassle Factor Form (2009)
American Academy of Pediatrics
The AAP online hassle factor form may be completed to report insurance administrative and claims processing concerns. The information provided will be used to assist the AAP and Chapters in identifying trends and facilitating public and private sector advocacy related to health plans.
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| 5. | Pediatric Coding Basics (2009)
Becky Dolan, MPH, CPC
This powerpoint presentation provides an overview of the Current Procedural Terminology (CPT), new and revised CPT codes, changes for 2009, inclusion of telephone care codes, and more.
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| 6. | Top Ten Current Procedural Terminology Questions (Including Modifiers) (2009)
American Academy of Pediatrics
This article provides answers to the most frequently asked questions related to CPT coding. Topics include sports physicals, postpartum depression screening, novel H1N1 influenza (swine flu), clean catch urine specimen, tuberculosis (TB) tests, screening for ADD/ADHD, vaccine counseling, hospital care, and international travel.
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| 7. | Pediatric ICD-9-CM Codes for 2009 (2008)
American Academy of Pediatrics
The International Classification of Diseases, Ninth Revision, Clinical Modification for 2009 brings many important new codes for pediatricians. Effective October 2008, there are more than 400 new codes, revisions, and deletions. Specific areas of note are included.
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| 8. | Practice Finance Checklist (2008)
American Academy of Pediatrics
This tool provides a basic overview of tips to ensure the financial health of your practice.
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| 9. | Reimbursement Toolkit (2008)
American Academy of Pediatrics
The Reimbursement Toolkit was created to assist American Academy of Pediatrics chapters in their payment-related advocacy work. This resource provides policy considerations, data-supported arguments, and other strategic advice for working toward higher payment as a chapter, most often via Medicaid payment. The toolkit also contains information on private payer advocacy and starting a pediatric council to work toward better insurance plan practices that can affect payment.
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| 12. | What Are Consumer-Driven Health Plans, Health Savings Accounts, and Health Reimbursement Accounts? (2008)
American Academy of Pediatrics
Consumer-driven health plans (CDHPs) are the fastest growing plan design across the county. In an attempt to reduce their health care costs, employers are shifting financial responsibility to their employees by offering health plans that feature high deductibles and coinsurance obligations. This article provides information on CDHPs, health savings accounts, and health reimbursement accounts based on the PediaLink Module "Contract Negotiation With Payers."
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| 14. | Children's Health Insurance Status and Medicaid/SCHIP Eligibility and Enrollment, 2007 (2007)
American Academy of Pediatrics
This report highlights the health insurance status of US children, the health insurance status of US children and Medicaid/State Children’s Health Insurance Program (SCHIP) eligibility of uninsured children, changes in employer-based and Medicaid/SCHIP coverage, uninsured US children, characteristics of US children 18 by health insurance status, parent and child worker status, and more. |
| 17. | Pediatric Council Start-Up Kit (2005)
American Academy of Pediatrics
Features an overview of AAP Pediatric Councils as well as detailed information on how and why to start one, who to include, the agenda for the Council, antitrust concerns and the 1996 statement issued by the U.S. Department of Justice, information about and samples of the hassle factor form, the executive summary of the managed care pediatric council teleconference from June 25, 2003, sample invitation letters and agendas, and a list of chapter activities with managed care organizations.
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| 19. | Anatomy of a New Code: The CPT and RUC Survey Processes (2003)
American Academy of Pediatrics
Features information on the current procedural terminology (CPT) process, specifically reasons for new codes, how to start the AAP's code development process, the AMA CPT process, the RUC process, and more.
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| 20. | 1997 CMS Documentation Guidelines (1997)
American Academy of Pediatrics
1997 publication from the Centers for Medicaid and Medicare Services (CMS) that provides guidance to physicians regarding documentation for evaluation and management services provided. |
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