Neonatology Billing Services
NICU billing starts before the patient has an insurance card. Getting it right takes specialty-specific discipline.
Why Neonatology Billing Needs a Specialist Team
Neonatology bills some of medicine's most intensive care through a per-diem code structure where each day's level — critical, intensive, or continuing care — must match documented status, birth weight, and services. Meanwhile the patient often has no insurance enrollment of their own yet.
We assign daily NICU codes from documentation, manage the transitions between care levels that auditors examine, bill delivery attendance and resuscitation correctly, and track every newborn's enrollment window so claims don't die in the coverage gap.
The Challenges We Solve
Per-Diem Level Accuracy
Daily critical/intensive/continuing care codes matched to documented status and birth-weight categories.
Care-Level Transitions
Step-downs and step-ups billed on the right days — the pattern payer audits check first.
Newborn Coverage Windows
Enrollment under the mother's plan tracked through the 30-day window; families guided before claims lapse.
Delivery & Transport Services
Attendance at delivery, resuscitation and neonatal transport billed with correct code combinations.
Frequently Asked Questions
NICU professional services bill per day, not per visit, with the code determined by care intensity and infant weight. One physician bills the day's global code regardless of how many times the team saw the baby — a structure unique to neonatal and pediatric critical care.
Most plans cover newborns under the mother automatically for 30 days, but claims after that need the infant's own enrollment. We track every baby's window, alert families through your case managers, and hold claims strategically so they process once enrollment lands.