October 17th, 2025

Note: New Content Noted with Asterisk* and Highlighted

Dear Kids Health First (KHF) Providers and Practice Administrators,

We have some important updates about payor updates, new programs, and upcoming events. There's a lot of information, and we want to keep you informed. Please read through this email carefully and let us know if you have any questions.

Important Updates

Last Chance to Register: Don’t Miss This HIPAA Compliance In-Person Event*

Cyber threats are rising, and new federal mandates make compliance more critical than ever. Join Brian L. Tuttle, a national HIPAA expert, for a practical session on:

Meeting new HITECH requirements
Avoiding costly compliance mistakes
Real-world lessons from recent cases

When: Oct. 30 | 10:00 AM–12:30 PM

Where: ROAM Galleria (Cumberland)

Registration: Free for Kids Health First members but registration is required. Registration is closing soon so make sure to save your spot. Register NOW!

Who’s Liable When AI Gets It Wrong?*

As AI becomes more common in clinical practice, questions about liability are growing. Medical Economics explores how responsibility may shift among physicians, health systems, and vendors—and what you can do to reduce risk. Read the article.

Ask a Peer: Use of Decadron in the Office*

Kids Health First recently surveyed practices on how they use oral Decadron in-office. Most respondents shared that they administer it for croup, asthma flares, or severe allergic reactions, often billing under HCPCS code J8540. While reimbursement is minimal, many practices continue to offer it to ensure timely care for patients.

See the full survey summary for insights on billing practices, coverage trends, and clinical use.

Ask a Peer: Developmental Screening Workflows with Phreesia*

We surveyed practices on how they manage infant and toddler developmental screenings within Phreesia. About half of respondents reported using the platform, most commonly pairing it with screening tools such as ASQ, M-CHAT, or PEDS. Some practices have integrated electronic workflows that save directly to the patient chart, while others continue to rely on paper or vendor-based forms.

See the full survey summary for details on screening tools, integration approaches, and workflow insights.

Managing the Holidays*

As the holiday season approaches, practices are planning how to balance patient care, staff coverage, and time off. In this month’s PPMA poll, most respondents reported closing on official holidays while offering reduced hours or urgent care options on Christmas Eve and New Year’s Eve. Others shared creative approaches like rotating provider schedules, incentive pay, and floating holidays to maintain coverage and morale.

See the full survey results for more insights and holiday scheduling ideas.

Cracking the Code: Spotting Automated Downcoding - FREE Webinar*

Thursday, Nov. 6

Noon to 1 p.m.

Several insurance companies have adopted automated algorithms to evaluate Evaluation and Management (E/M) service levels based on diagnosis codes and claims history. These systems are designed to downcode E/M services—often by one level—when the documentation is deemed insufficient to support medical necessity for the higher level of service.

This webinar will equip attendees with the tools to:

Identify downcoding patterns within claim remittances
Assess practice workflows to determine whether to appeal or provide targeted provider education
Develop effective correspondence to demonstrate compliance and challenge payer algorithms

Join coding and revenue cycle experts Ashley Carson and Mary Suhr to learn how to protect your practice’s revenue, ensure accurate coding, and push back against unjustified payer tactics. Please note there are no CEUs offered for this webinar.

Click here to register.

COVID-19 Vaccine Guidance and Malpractice Coverage*

Some practices have asked whether administering a vaccine for an off-label use—or following the AAP’s COVID-19 vaccination schedule—could impact malpractice coverage. According to Curi, off-label use alone does not affect coverage and can still fall within the standard of care. Curi will defend and indemnify a claim for vaccine injury in accordance with policy terms and standard claims procedures, which may include referral to the National Vaccine Injury Compensation Program.

For more information, see Curi’s detailed FAQ flyer.

October Is Down Syndrome Awareness Month*

The Down Syndrome Association of Atlanta (DSAATL) offers a wide range of resources to help providers, practices, and families support individuals with Down syndrome. Explore their tools and community programs at dsaatl.org.

Helpful links:

Transportation Assistance: dsaatl.org/transportation
New Parent Resources: dsaatl.org/new-parent-resources
Medical Guidelines: dsaatl.org/medical
Emory Down Syndrome Clinic: Emory Down Syndrome Clinic

Reminder: Don't Miss the Coding Webinar

Join us on Thursday, November 20 from 10 am to Noon, as we host a pediatric coding webinar to prepare for 2026 coding updates and guidelines. In this webinar we will focus on:

2026 CPT and Diagnosis Code updates
Understanding best practices in billing and coding to maximize revenue while adhering to coding regulations

The presenter for this event is Mary Suhr, Director, Revenue Cycle Consulting with Revenue Cycle Coding Strategies.

Who can attend?

This webinar is designed for practice administrators, lead physicians, and billing and coding team members, but everyone from your practice is welcome to join.

This event is free to attend but registration is required.

Reminder: Watch this Webinar on Phishing & Protect your Practice*

Phishing causes 57% of costly healthcare security incidents and 36% of all data breaches. Watch this brief webinar from Sterling Seacrest Pritchard to learn how to spot and prevent attacks.

Next Steps

Ask all providers and staff to watch the training and document completion to ensure compliance and reduce risk

Watch the webinar now.