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Reliable Pediatric Billing Services for Growing Pediatric Practices
Running a pediatric practice means seeing high patient volumes, managing Medicaid-heavy payer mixes, and dealing with billing rules that change constantly. Most billing teams can't keep up and your revenue takes the hit. Our pediatric billing services handle every code, every claim, and every denial so your practice gets paid accurately for every visit. Most practices see 20 to 25% more in collections within 90 days of switching.
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Why Pediatric Billing Goes Wrong and How We Fix It
Pediatric billing has more room for error than most practices realize. The same billing mistakes show up again and again and most of them are completely preventable.
Well Child Visit Bundling Gets Billed Incorrectly
Well child visits have strict bundling rules and most billers either bundle what should be separate or separate what should be bundled. We know exactly how to bill every well child encounter so you capture the full value of every visit without triggering denials.
Developmental Screening Reimbursement Gets Left Out
Hyperbaric oxygen therapy and skin substitute procedures routinely require prior authorization. If your team submits before auth is confirmed, your highest-value procedures carry the highest denial risk. We prevent this before it starts.
Vaccine Administration Coding Gets Missed
Vaccine administration codes are separate from vaccine supply codes and both need to be billed correctly every time. Our team codes every vaccine encounter completely so administration fees and supply costs are captured on every single claim.
Newborn Care and Hospital Billing Gets Overcomplicated
Newborn care, initial hospital visits, and subsequent inpatient services all have their own coding rules. Bill the wrong level of service or miss a subsequent visit and you lose reimbursement you earned. We handle newborn and inpatient coding with the same precision as office visits so nothing gets missed.
Medicaid Rules Vary by State and Get Ignored
Vaccine administration codes are separate from vaccine supply codes and both need to be billed correctly every time. Our team codes every vaccine encounter completely so administration fees and supply costs are captured on every single claim.
Chronic Care and Sick Visit Coding Gets Confused
When a child comes in for a well visit but also has a chronic condition or acute illness addressed in the same encounter, billing both correctly requires specific modifier use and documentation. Most billers skip the additional code entirely. We capture every billable service in every encounter so your practice never leaves a payable charge behind.
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What end-to-end pediatric billing actually looks like
Pediatric billing gets complicated fast with well-child visit bundling, vaccine administration coding, and Medicaid fee schedules that vary by state. Our pediatric billing specialists know exactly how to navigate all of it from newborn care to adolescent preventive visits. You get paid accurately for every patient encounter without the administrative burden.
Eligibility and benefits verification
Before every visit we confirm insurance coverage, preventive care benefits, Medicaid eligibility, and any referral or authorization requirements. Your front desk spends less time on the phone and more time with patients.
Prior authorization tracking
We submit and track prior auth requests for specialist referrals, behavioral health services, and advanced diagnostics. Every approval is logged with its validity window and renewed before it lapses so your team never delivers a service that won't get paid.
Claim build and pre-submission scrubbing
Claims are built with accurate preventive and sick visit coding, vaccine administration codes, screening codes, and diagnosis linkage. Our scrubber catches errors before the claim reaches the clearinghouse so denials don't happen in the first place.
Denial management with root-cause analysis
Every denial gets reviewed, root-caused, and appealed with full supporting documentation. We track denial patterns across your claim volume to catch systemic issues before they compound into bigger revenue losses.
AR follow-up and payment reconciliation
Unpaid claims are worked by aging bucket with consistent follow-up until resolved. Payments are posted and reconciled against expected reimbursement. Underpayments on preventive visits, screenings, and vaccine administration are flagged and disputed.
We were underbilling vaccine administration codes for over a year without knowing it. 3 Axis caught it in the first audit and fixed it immediately. Our monthly collections went up by over $18,000 and our denial rate dropped significantly within the first 60 days.
Dr. Emily Carter
Client Review
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