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511 SW 10th Ave 1206,
Portland, OR United States

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Pediatric

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24/7 Support: +1 800-123-1234

Expert Medical Billing Services for Pediatric Practices

Streamline your billing, reduce denials, and boost your revenue with specialized pediatric billing solutions tailored to your practice’s needs. We understand that pediatric billing presents unique challenges. With a wide range of services from routine check-ups to immunizations, emergency care, and complex treatments, pediatric billing requires expertise in coding, documentation, and payer guidelines. Ensuring your practice gets reimbursed correctly for all the services provided to children can be complicated, especially with pediatric care’s variety of preventive, diagnostic, and therapeutic services.

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98% First-Pass Pay Rate

We achieve a high first-pass claim approval rate through our expert knowledge of pediatric coding and payer rules, reducing delays and speeding up reimbursement.

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30% Reduction in AR Days

Our efficient billing and follow-up process reduces the average accounts receivable days, ensuring faster payments and improving your practice’s cash flow.

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15% Revenue Increase

Practices that partner with us typically see a 20% or higher revenue increase due to better billing practices, fewer claim denials, and more accurate coding.

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99% Claim Accuracy

: With our attention to detail and expertise in pediatric billing, we ensure the accuracy of every claim submitted, minimizing rejections and improving reimbursement.

Common Billing Challenges in Pediatrics

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Diverse Services and Coding for Pediatric Care

Orthopedic procedures often involve complex coding for both surgical and non-surgical treatments, including joint replacements, fractures, and diagnostic tests. Correctly coding these procedures is essential to ensure accurate billing and prevent claim rejections.

How We Solve It:

Our certified coding specialists are highly experienced in pediatric-specific CPT, ICD-10, and HCPCS codes. We ensure that every service, whether it's a routine check-up or a complex procedure, is correctly coded to avoid errors and ensure maximum reimbursement.

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Complex Billing for Vaccinations and Preventive Services

Immunizations are a core part of pediatric care but can be complex to bill due to varying insurance coverage, reimbursement rates, and specific vaccine administration codes.

How We Solve It:

We ensure that immunizations and preventive services are billed correctly, taking into account different payer rules, and ensuring that your practice is reimbursed for vaccines and their administration in full.

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Coordination of Care and Multiple Payer Systems

Pediatric practices often treat children covered by Medicaid, private insurance, and other third-party payers. Coordinating claims across these multiple payer systems can be difficult, with different billing requirements, rules, and rates.

How We Solve It:

We manage the intricacies of dealing with various payers, ensuring that claims are submitted according to each payer’s specific guidelines. Our team reduces the administrative burden on your practice and ensures timely reimbursement for all services.

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Denials Due to Missing or Incorrect Documentation

Pediatric billing often requires specific documentation for both preventive and therapeutic services. Without accurate or complete documentation, claims can be denied or delayed.

How We Solve It:

Our team works closely with your practice to ensure that all necessary documentation is gathered, complete, and submitted with every claim. We help ensure that well-child visits, immunizations, and other services are fully supported by the appropriate medical records.

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Claim Denials and Appeals

Pediatric claims can face frequent denials due to coding errors, missing documentation, or incorrect information on claims. The appeal process can be time-consuming and challenging to navigate

How We Solve It:

We handle all aspects of denial management. Our team identifies the reasons for denials, handles appeals, and works directly with payers to resolve issues quickly. This helps minimize the impact of denials on your practice's cash flow.

How We Solve Pediatric Billing Challenges

Pediatric-Specific Coding Expertise
Our certified billing specialists have extensive knowledge of pediatric-specific coding for preventive, diagnostic, and therapeutic services. We ensure that every claim is coded accurately, reducing errors and ensuring proper reimbursement.
Immunization and Preventive Care Billing
We specialize in billing for immunizations and preventive services. Our team ensures that all vaccines, well-child visits, and screenings are billed correctly, in compliance with payer-specific requirements, and that your practice receives proper reimbursement.
Streamlined Multi-Payer Coordination
We understand the complexities of working with multiple payers, including Medicaid, private insurance, and commercial plans. Our billing specialists ensure that all claims are submitted in compliance with each payer’s requirements, maximizing your reimbursement and reducing delays.
Proactive Denial Management and Appeals
We monitor claims closely to identify and address any denials before they become a significant issue. If a claim is denied, we swiftly investigate the cause and submit appeals with the correct information, ensuring your practice gets paid for the services you provide.
Comprehensive Documentation Support
Our team ensures that your practice maintains the proper documentation for all services provided, including immunization records, well-child exam notes, and diagnostic test results. We make sure that every claim submitted is fully supported by the required clinical documentation, minimizing delays and denials.
Compliance and Documentation
We ensure that all medical necessity and evaluation and management (E/M) documentation is complete, accurate, and compliant with payer and regulatory requirements. This helps your practice avoid audits and ensures that you are reimbursed properly for all services rendered.

What Our Pediatric Clients Are Saying

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"As a pediatrician, I wanted my focus to stay on children’s health—not billing. NY Practice Partner took charge of our revenue cycle management and gave us peace of mind. Our pediatric clinic now runs efficiently, reimbursements are reliable, and families experience better continuity of care without delays."

Dr. Jason Miller, Pediatrician

"RCM is the backbone of a thriving pediatric practice, and NY Practice Partner has been exceptional. They keep our collections steady and reduce stress for both doctors and staff. Thanks to them, we spend less time on paperwork and more time with the children who need our care."

Dr. Olivia Grant, Pediatrician

"BrightCare Pediatrics used to face delayed payments and high denials that affected our financial planning. After working with NY Practice Partner, everything changed. Their revenue cycle management services brought efficiency, steady collections, and a clear path for sustainable growth in our pediatric practice."

Monica Rivera, Practice Manager – BrightCare Pediatrics

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