Pediatrics billing & credentialing
Well-child visits, vaccines and sick-plus-well same-day care: pediatric billing has its own rulebook. We know it, so your preventive and immunization revenue is fully captured.
- Focus
- Well-child, vaccines, VFC
- Same-day
- Sick + well, mod 25
- Clean claims
- 95%+ first pass
- A/R
- Worked within 48 hrs
Why pediatrics is different
Pediatrics runs on preventive visits and immunizations, and the vaccine-administration and VFC rules are where practices quietly lose the most money.
We code preventive well-child visits by age, bill vaccine administration correctly with counseling, separate VFC from private stock, capture developmental screening, and protect same-day sick-and-well visits with modifier 25.
What our pediatrics billing covers
- Age-based preventive / well-child visits (99381–99394)
- Vaccine administration with counseling (90460/90461) coded right
- VFC (Vaccines for Children) separated from private stock
- Developmental and autism screening (96110, 96127) captured
- Sick + well same-day visits protected with modifier 25
- Newborn and hospital care coded to the correct day and setting
Credentialing for pediatrics
We enroll your pediatricians and NPs across Medicaid/CHIP and commercial plans, and get your VFC participation squared away.
- Medicare (PECOS) & Medicaid enrollment for every provider
- Commercial payer paneling matched to your patient mix
- CAQH build, attestation & ongoing maintenance
- Revalidations and re-credentialing tracked before they lapse
- Medicaid/CHIP enrollment prioritized for your patient population
- VFC program enrollment support alongside payer paneling
What changes for these providers, step by step: see nurse practitioner credentialing.
Want pediatrics claims that actually pay the first time?
Send us a sample of your denials.
We’ll show you exactly where the money is leaking, free.