▸ Bill for supplies. Consider relying on parents' good will and ask them to replace the item used, such as an ace bandage, sling, crutches, or a splint. But check the Health Care Financing Administration's Common Procedural Coding System for the codes to use if you need to bill for supplies you have purchased.
▸ Charge for filling out forms. Consider setting a fee, posted in your office, to fill out forms for camp, school sports, and day care centers. Collect this fee up front.
▸ When dealing with insurance companies, try to speak with a pediatric medical director. He or she may be more responsive to a pediatrician's issues, but remember that the insurance companies can do whatever they want. They can even pay two different doctors different amounts for the same service.
The process of deciding which code is the most appropriate depends on several factors. Complex or chronic conditions that take more time, such as check-ups for premature infants, should have some expectation of added E/M codes.
The bottom line is that pediatrics is a business as well as a calling, and you need to stay in business to help patients, Dr. Scott said. Do not apologize for fees, he added, saying it makes sense—and cents—to charge appropriately for services given.