A pediatric clinic in Massachusetts was struggling with delayed payments—especially for common services like well-child visits, immunizations, and developmental screenings. High claim denials and slow reimbursements were hurting cash flow.
After partnering with MBW RCM, a leader in pediatric billing services, the practice reduced its days in A/R by 24%, improved collections, and simplified its revenue cycle management—all in just six months.
Client Overview
-
Location: Massachusetts, USA
-
Specialty: Pediatric Medical Billing Services
-
Monthly Patient Volume: 400+
-
Revenue Cycle Volume: $350,000
-
Previous Collections: $260,000
-
Average Days in A/R (Before): 45
Despite strong patient volume, inefficient pediatric billing workflows and inconsistent claim follow-ups were slowing down payments.
Challenges in Pediatric Medical Billing Services
-
Claim Denials for Pediatric Services
Frequent rejections for child wellness visits, vaccine billing, and screening services due to coding or documentation errors.
-
Complicated Insurance Rules
Varying payer guidelines led to errors in submission—especially with Medicaid and commercial plans.
-
Authorization and Referral Issues
Manual tracking caused delays in getting required approvals for certain pediatric procedures.
-
Pediatric Medical Coding Errors
Mistakes in CPT and ICD-10 codes for routine care created unnecessary resubmissions and lost revenue.
-
Delayed Claim Follow-Up
Without a structured A/R strategy, overdue claims were often left unresolved for too long.
Our Approach
We performed a comprehensive audit of their pediatric revenue cycle and implemented improvements designed for the specific needs of pediatric practices:
Results After 6 Months
-
Reduced pediatric days in A/R from 45 to 34
-
Monthly collections increased by 18%
-
Claim denials dropped by 30%
-
Reimbursement turnaround improved by 11 days
-
Saved over 15 administrative hours per week
By optimizing its pediatric billing operations, the clinic now benefits from accelerated reimbursements, reduced error rates, and enhanced overall financial performance.
Conclusion
Pediatric practices often face unique billing challenges that require more than just general RCM support. From accurate pediatric coding to payer-specific claim submission and timely follow-up, MBW RCM delivers customized solutions that work.
This Massachusetts clinic is now operating more efficiently, collecting faster, and spending less time on paperwork—thanks to our dedicated approach to pediatric medical billing.
Looking to Improve Your Pediatric Revenue? (Download the Full Case Study)
Let’s help you improve pediatric revenue performance.