Killer 01
VFC admin coding misses
Per-component vaccine administration logic is often underbilled.
Pediatric billing built for
high-volume, low-margin reality.
Vaccine administration, preventive plus sick visit logic, developmental screening capture, and Medicaid MCO operations.
Aetnapaneled
BCBSpaneled
UnitedHealthcarepaneled
Cignapaneled
Humanapaneled
Kaiser Permanentepaneled
Tricarepaneled
Anthempaneled
Centenepaneled
Molinapaneled
Medicarepaneled
ElevancepaneledAetnapaneledBCBSpaneledUnitedHealthcarepaneledCignapaneledHumanapaneledKaiser PermanentepaneledTricarepaneledAnthempaneledCentenepaneledMolinapaneledMedicarepaneledElevancepaneledQuiet killers
Where pediatrics revenue leaks. Three patterns we audit on every onboarding and fix first.
Killer 02
Same-day well and sick undercoding
Modifier 25 usage often missed for dual-service pediatric visits.
Killer 03
Screening codes left out
Developmental and behavioral screens performed but not billed.
How we work
Pediatrics operations, built right.
A specialty pod that lives inside your workflow, not a call-center model. These are the controls we run on every claim from day one.
Pediatrics pod · operating playbookActive
01
Per-component vaccine coding controls
✓02
Modifier 25 workflow
✓03
Screening code capture audit
✓04
Medicaid MCO denial pattern tracking
✓Reviewed quarterly · last update May 2026v2.6
Codes & modifiers
The pediatrics code family.
What we actively scrub on every claim. Coders in this pod work these codes daily with payer edits and documentation patterns mapped into weekly QA.
CPT/HCPCS reviewed quarterly · payer LCD/NCD subscriptions · CCI updates · claim-level audit logs.
99381-99394
90460
Vaccine admin first component
90461
Each additional component
99202-99215
96110
Developmental screen
96127
Brief emotional/behavioral
Credentialing
Panels we already work for pediatrics. Enrollment, revalidation, and CAQH upkeep included.
✓State Medicaid and MCO panels
✓Commercial pediatric plans
FAQ
Frequently asked.
Practical questions we get during diligence. Ask anything we missed.
Do you handle Medicaid complexity?+
Yes, including state plan and MCO carve-outs.
What about newborn billing?+
Yes.
Can you code behavioral screenings?+
Yes, with appropriate diagnosis support.
30-day review
A quick conversation, not a long form.
Six short questions. We use them to route your request to the right specialist and return a focused recommendation summary.
HIPAA-safe by default
We don't ask for PHI. Practice-level data only.
~ 90 seconds
Press Enter to continue. No long intake form.
Based on what you've told us...
We route your request to the billing pod that can move fastest.