Pediatrics Billing That Grows With Your Practice
Between age-specific coding rules, vaccine program complexities, and the constant shuffle of family coverage changes, pediatric billing requires more than just medical expertise—it needs patience and precision. We specialize in turning your compassionate care into collected revenue, whether it's properly bundling a well-child visit or fighting for ADHD management reimbursements.
Last year, we helped a 6-provider pediatric group recover $112,000 in previously denied claims by correcting age-modifier errors alone. But what our partners value most is getting back 10+ hours per week previously spent on hold with Medicaid or explaining vaccine billing to confused parents.
Get Your Free Practice AnalysisAge-Specific Coding That Actually Makes Sense
We navigate the developmental milestones that impact billing:
- Newborn vs infant - Correct coding for first 28 days vs subsequent visits
- Adolescent privacy - Handling sensitive services confidentially
- Transitional care - Proper coding for patients aging out of pediatric coverage
Real Example: For a 15-month well visit, we ensure proper documentation of:
✓ Developmental screening (96110) ✓ Autism screening (96110-59 if separate) ✓ Vaccine administration (90460) ✓ Anticipatory guidance
Vaccine Billing Without the Headache
We've mastered the complexities of:
VFC Program
- Proper use of SL modifiers
- Mixed public/private billing
Commercial Plans
- NDC code requirements
- Combination vaccine billing
Pro Tip: We maintain a state-by-state database of VFC program requirements and Medicaid vaccine policies.
Well-Visits That Work Harder
We help capture all billable components:
EPSDT Services We Optimize:
✓ Developmental screenings ✓ Behavioral assessments ✓ Nutritional counseling ✓ Oral health risk assessments
Family Coverage Made Simple
We track the details that matter:
Birthday Alerts
Coverage changes
Sibling Policies
Same-day visits
Custody Notes
Billing permissions
Our Verification Includes:
✓ Real-time Medicaid eligibility ✓ Commercial plan vaccine coverage ✓ Secondary insurance coordination ✓ Out-of-network alerts
"After implementing their pediatric billing system, our collections for developmental screenings increased by 40%. They caught that we were missing separate billing for autism screenings during well-visits—that one change added $28,000 annually to our bottom line. Now I can focus on my patients instead of paperwork."
Dr. Jamal Williams
Growing Smiles Pediatrics
Ready to Spend More Time With Patients?
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