Industries & Specialties
Well-child schedules, vaccine administration units, developmental screening, and a payer mix heavy with Medicaid and CHIP. Small coding errors repeat thousands of times a year — we stop them at source.
Who We Serve
Our pediatrics team maintains its own payer playbook, denial library, and coding reference — kept current with CMS, state Medicaid, and commercial payer updates.
We'll walk you through the Medicaid rules, vaccine administration coding, and denial patterns we handle for pediatric practices every day.
Cluster 01
The backbone of a pediatric practice — schedule-driven visits where age bands, vaccine administration units, and screening add-ons decide whether the encounter is paid in full.
4 Specialties
Age-banded preventive visits from newborn through adolescence, frequently combined with a problem-oriented visit on the same day.
Vaccine product and administration billing, including state Vaccines for Children stock and privately purchased doses.
Standardized screening instruments delivered at recommended intervals and at parental request.
Seasonal, high-volume examinations with widely varying payer and self-pay treatment.
Get an immunisation and preventive-services audit on a sample of your recent claims.
Cluster 02
Same-day, unscheduled, and long-term management work where visit-level accuracy and documentation of medical decision-making carry the margin.
6 Specialties
Unscheduled acute visits, frequently added onto an existing preventive appointment.
Extended-hours and weekend care for non-life-threatening presentations.
Ongoing management combining office visits, testing, nebuliser treatments, and immunotherapy.
Hospital newborn attendance, nursery rounds, and the first office visits after discharge.
Complex and medically fragile children requiring care coordination across multiple providers.
Feeding assessment and lactation consultation delivered in-office and via telehealth.
We'll review your top denial reasons and show where preventive-plus-sick visits are being written off.
Cluster 03
Time-based, session-driven services where unit accuracy, authorization limits, and parity rules drive both compliance and collections.
4 Specialties
Assessment, rating-scale review, medication titration, and school coordination over repeated visits.
Integrated behavioral health delivered inside the pediatric practice or by co-located clinicians.
Confidential adolescent care with its own consent, screening, and statement-handling requirements.
Speech, occupational, and physical therapy for developmental and post-acute needs.
Authorization limits, unit rules, and recert deadlines — managed so therapy and behavioral claims land clean.
Cluster 04
Coverage-first lines of business where eligibility churn, state program rules, and facility relationships determine payment integrity.
3 Specialties
State programs and managed care plans that carry most of the pediatric payer mix, each with its own rules.
Intensive and continuing care for newborns, billed per day against tightly defined acuity levels.
Cardiology, neurology, gastroenterology, and endocrine clinics run within a pediatric group or hospital.
Who We Work With
Solo and small-group pediatricians who need a full billing department without the payroll.
Coordinated billing and credentialing across locations, providers, and payer contracts.
High-volume claim processing, AR recovery projects, and dedicated FTE resources.
Next Step
We build playbooks on request. Tell us what your pediatric practice offers and we'll show you how we'd bill it.
