Stop Revenue Leaks with Expert Medical Billing Services
Pediatric Billing Services
Maximize reimbursements with child-specific coding and denial prevention through our specialized pediatric billing solutions.
Pediatric-Specific Coders – Experts in 99202–99215, vaccine codes (90460–90461), and well-child visits.
Denial Defense – 94% clean claim rate for pediatric practices (vs. 78% industry average).
Vaccine Billing Mastery – Proper coding for VFC & private-pay immunizations.
Fast Payments – 88% of claims paid within 14 days.
EHR-Integrated – Works with PCC, Epic, and other pediatric EHRs.
Transparent Pricing – 3–5% of collections or flat $499/month for small practices.
HIPAA-Compliant
Pay as you go
No fixed contract
Pediatric Billing Services
medical billing services
Smooth Transition Between EHR/EMR Systems
Efficient Electronic Funds Transfer (EFT), EDI, and ERA Setups
Claims Submission Within 24 Hours
Prompt follow-up with payers.
Free CAQH maintenance
Free credentialing & revalidation
Comprehensive Revenue Cycle Management (RCM) Services
Appeals & Adjustments.
Referral Coordination with Other Doctor Offices
Reimbursement Strategies for Optimized Billing
Why 68% of Private Practices lose 15-30% of their revenue to these preventable issues
Biggest Pediatric Billing Challenges
Vaccine Billing Errors
35% of pediatric practices underbill VFC (90460-90461) and private-pay immunizations, losing $18k+/year.
Our Expertise:
AAP-certified coders achieve 98% vaccine reimbursement accuracy
Well-Child Visit Denials
Incorrect bundling of 99381-99395 leads to 25% denial rates for preventive care.
Our Expertise:
Custom claim scrubbing reduces denials to <5%
Medicaid Timely Filing
60-180 day state-specific windows cause $22k+ annual losses for pediatric practices.
Our Expertise:
Automated Medicaid deadline tracking with 48hr submissions
Behavioral Health Coding
96110-96127 and ADHD management codes are denied 40% more than other services.
Our Expertise:
AAP-recommended documentation templates
PCC EHR Gaps
15% of billable units (e.g., developmental screens) are missed in auto-billing.
Our Expertise:
Manual charge capture for 100% billing accuracy
Patient Collections
High deductible plans result in 45% of patient balances >90 days past due.
Our Expertise:
Text/email payment plans boost collections by 60%
Schedule a Consultation with Our Medical Billing Experts
We understand your need to keep things small, intimate, and personalized. Our medical billing specialists for independent small practices thoroughly study your needs and offer custom-made solutions.
Pediatric Billing Services
We Offer
Pediatric Billing Services
Process
Benefits of Outsourcing
Pediatric Billing Services
Dual-Specialty Coding
Experts in both pediatric (99202-99215) and podiatry (11719-11721) codes prevent cross-specialty denials.
30% fewer coding errors
Medicaid Optimization
Maximize reimbursements for pediatric podiatry (e.g., gait training, orthotic management).
22% higher Medicaid collections
Developmental Focus
Proper billing for flatfoot (736.30) and toe-walking (781.2) assessments.
95% clean claim rate
Orthotic Billing
Correct L-codes (L3000-L3649) submission for pediatric orthotics.
40% faster orthotic approvals
EHR Bridge
Seamless integration between pediatric (PCC) and podiatry (EHR) systems.
100% charge capture
Compliance Protection
AAP/APMA-compliant documentation for audits.
Zero audit penalties
Pediatric Billing Services
FAQs
How do you bill for vaccine administration (90460-90461)?
We follow AAP guidelines to properly bill:
- +90460 for first vaccine
- +90461 for each additional
- VFC vs. private-pay differentiation
- Appending SL modifier for state-supplied vaccines
What's your denial rate for well-child visits (99381-99395)?
Just 4% vs. industry average of 25% by:
- Preventing bundling with sick visits
- Appending 25 modifier when needed
- Documenting all 8 Medicare-required elements
Do you handle pediatric behavioral health (96110-96127)?
Yes, including:
- ADHD assessments (96110-96111)
- Developmental screens (M-CHAT, ASQ)
- Autism spectrum billing (0362T)
How do you track Medicaid timely filing?
State-specific tracking with alerts:
- CA: 90 days
- TX: 95 days
- NY: 120 days
- FL: 180 days
Can you bill for lactation counseling (99401-99404)?
Yes, including:
- Initial 99401 (15 mins)
- Follow-up 99402 (30 mins)
- ICD-10 Z39.1/Z39.2 coding
How do you handle PCC EHR billing gaps?
We manually capture:
- Developmental screens (often missed)
- Hearing/vision tests
- Fluoride varnish (D1206)
What's your process for WCC modifier 25?
Strict AAP-compliant rules:
- Separate documented problem
- Distinct time/effort beyond preventive care
- Never with vaccine-only visits
Do you support school/sports physicals?
Yes, with proper coding:
- 99381-99397 + V20.2
- Separate charge for forms completion (99080)
- State-specific Medicaid rules
How do you improve patient collections?
Proven strategies:
- Text/email payment reminders
- Sliding scale options
- Upfront cost estimates for high-deductible plans
What's your onboarding process?
3-step transition:
- Free audit (identify revenue leaks)
- PCC/EHR integration (3-5 business days)
- Staff training (1-hour webinar + cheat sheets)
Pediatric Billing Services
Insurances Covered
Medicare
Medicaid
VA Health
TRICARE
ACA Marketplace
UnitedHealthcare
Aetna
Cigna
Humana
Anthem
BCBS National
BCBS Alabama
Florida Blue
BCBS Michigan
Empire BCBS
Horizon BCBS
BCBS NC
Highmark BCBS
BCBS Texas
Premera BCBS
Kaiser Permanente
Molina
Centene
Oscar Health
Health Net
CDPHP
Capital Blue
Independence BC
CareFirst
Regence BCBS
UHC Medicare
Humana Medicare
Aetna Medicare
Cigna Medicare
BCBS Medicare
Trusted Medical Billing Services
Verified Results
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I am a licensed psychotherapist and could not be more pleased with the efficient, professional services from RX credentialing services. No AI or bots here. Instead, RX offers real human beings who understand the needs of solo providers or group practice owners who are spread thin and have to wear many hats. Rx has hired talented individuals, like my account manager, Tyler, who will go the extra mile for you to ensure credentialing goes smoothly. We hit a hiccup on the road to becoming credentialed, but Tyler quickly intervened, advocating for my business so that the issue was resolved and I was approved for various insurance panels--some which have very high bars or administrative requirements. RX handled it all, informing me through each step of the process with clear and concise credentialing updates that put my fears to rest. Their services are kind of like therapy for therapists, because when you worry less about admin burdens, you can better focus on the client, while growing your business capacity. I would highly recommend them to any solo or group practice needing such services.
RxCredentialing has been a wonderful partner in helping with my credentialing for my new primary care practice as well as are assisting me with a few other services. They are very knowledgeable and most importantly they are not pushy in working with my needed timeline. Moreover, they are very responsive, and I am looking forward to expanding our relationship to include their other services such as medical billing. I was fortunate to find them while searching the web and so refreshing to deal with an organization that is really focused on helping me establish a medical practice the smart way and not just spend money foolishly on things I do not need until the time is right.
Adam and his team are excellent at what they do. They walk you through every step of the process. Highly recomend Adam and his team. always responding in quickly.
Attention to detail
Very attentive and efficient
Always available to explain things or answer questions or concerns
Very attentive and efficient
Always available to explain things or answer questions or concerns
Tyler has been an excellent person to work with. He kept us (our clinic) informed of our status throughout the credentialling process. They did the "heavy lifting" tracking down and following up so we didn't need to. Because this company handled our credentialling process, it allowed our company to focus on our number one priority--patient care. Thanks for taking care of us!!
they handled the issue quickly and professionally. I truly felt supported and confident in their assistance.
I can’t say enough great things about RX Credentialing! From the beginning, they’ve been incredibly efficient, responsive, and always a pleasure to work with. Anytime I had a question or needed assistance, they got back to me quickly with clear, helpful answers. They made the entire credentialing process smooth and stress-free! It truly feels like they care about their clients and go the extra mile to make sure everything is handled correctly and on time. I would highly recommend RX Credentialing to anyone looking for a credentialing partner who delivers every time!
David is wonderful very responsive and on top his work. Great experience.
Making the decision to use Rx Credentialing for my billing service was a game changer for my practice. Solo practice as an NP and lipid specialist has been challenging for sure. Rx Credentialing has provided the professional knowledgeable support I needed. I am so grateful to be partnering with them for my billing and credentialing needs.
The staff is great and very helpful. I have been with them for 2 years with no complaints. I am very satisfied with their service.
I have been working with this company for over a year and I have no complaints…They are really the best at what they do.
Trusting a third party with your sensitive information can be difficult. I encountered this challenge while seeking credentialing services for my business with various insurance providers. Although I received numerous proposals from credentialing firms, I was uncertain about the security of my personal data. A trusted colleague recommended Rx Credentialing LLC, based on her positive experience. I decided to engage their services, and I’m pleased to report that they handled my information securely. Moreover, their expertise and competitive pricing make them an excellent choice for anyone needing credentialing support.
Adam is very professional and kind, always responsive when I need assistance. I have billing service through this company which has been going good so far. I was lucky enough to get a wonderful virtual assistant from Adam, I don’t know what I would do without her.
Rx Credentialing did a phenomenal job assisting with credentialing for my Ophthalmology practice start-up. Tyler is responsive and kept me up to date throughout the entire process. I would recommend Rx Credentialing to anyone hands down the best. Dr. Montenegro.
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