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Specialty billing

Pediatrics medical billing

Pediatric billing combines well-child schedules with vaccine administration rules and, usually, a heavy Medicaid mix.

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What we handle for pediatrics practices

Well-child visits, vaccine administration and Medicaid plans billed correctly.

Well-child visits

Billed against the recommended periodicity schedule for each age.

Immunizations

Vaccine products and administration coded separately, including multi-component vaccines.

Screening instruments

Developmental, autism and behavioral screening billed where performed.

Medicaid and CHIP

State-specific program requirements applied.

Common pitfalls

Where pediatrics claims go wrong

These are the errors we look for first when reviewing a practice in this specialty. If any sound familiar, a billing review will tell you what they are costing.

  • Administration codes under-billed on multi-component vaccines.
  • A sick complaint addressed at a well visit but billed without modifier 25.
  • State-supplied vaccine stock billed as though the practice had purchased it.

Not sure where your revenue is leaking?

Book a free review. We will look at your recent claims, denial patterns and A/R aging, and tell you what we find — whether or not you work with us.