- Pediatric Coding Specialists
Pediatric Medical Billing Services
Pediatric billing is deceptively complex. One wrong modifier on a sick visit + well-check combo, one missed vaccine administration code, or one age-based CPT error—and you're losing $8K-$20K monthly.
Neo MD fixes that with pediatric-certified coders who understand age-based code selection, vaccine billing matrices, and how to bill same-day sick + well visits without denials.
95-97%
First-Pass Claim Acceptance
+21%
Average Revenue Increase
90
Days to Results
- Practice Revenue Health Audit
Is Your Pediatric Practice
Bleeding Revenue?a
If you fall behind your revenue goals, it’s time to get our professional consultation about the Revenue Cycle Management process. If any of these are happening, you’re losing $110K–$260K+ annually:
Visible Revenue Bleed
Immediate Impact
Well-Child Visit Claims Denied
Preventive vs sick visit coding confusion
Immunization Claims Rejected
Missing VFC documentation or wrong CPT codes
Developmental Screening Claims Denied
Missing standardized tool documentation
Asthma Treatment Claims Delayed
Nebulizer and medication code bundling errors
Same-Day Sick and Well Visit Claims Bundled
When modifier 25 should've been applied
Prolonged Service Code Missing
Not capturing extended visit time (99354-99355)
Invisible Losses
According to AAP and MGMA pediatric benchmarking data, practices lose 18%–25% of revenue due to:
Preventive Visit Age Bands
Wrong age-based code selection
Vaccine Administration Codes
Missing counseling component
Developmental Screening
Not billing 96110/96127 separately
Same-Day Sick and Well
Missing modifier 25 documentation
Prolonged Service Time
Not capturing visits over 40 minutes
Care Coordination Billing
Not using 99490 for chronic conditions
VFC Vaccine Documentation
Incorrect state-supplied vaccine coding
Behavioral Health Integration
Missing 96127 screening opportunities
"You didn't train for years to fight with insurance companies. But right now, coding errors cost more than a pediatrician's salary."
$260,000+
- Industry Problem
Why General Medical Billing Companies Fail Pediatric Practices
Pediatric billing requires specialty expertise that general billers don’t have.
Age-based coding chaos
Can't select the correct preventive visit codes by age
VFC documentation blindspot
Don't handle state-supplied vaccine billing
Sick and well confusion
Can't properly code same-day visits
Vaccine administration miss
Don't bill counseling component separately
Developmental screening errors
Don't capture 96110/96127 opportunities
Medical necessity gaps
Can't document behavioral health screenings
Prolonged service underbilling
Don't track time for 99354/99355
Care coordination blindspot
Miss chronic care management billing (99490)
Result: 15%–22% denial rates, 45-60 day payment cycles, and constant staff time wasted on resubmissions.
- The NEO MD Difference
Specialty-Focused Billing Built for Pediatric Complexity
Specialty-Exclusive Billing Built for Complex Oncology Workflows.
Pediatric-Certified Coding Teams
- Expert knowledge of age-based preventive code selection (birth through 21 years)
- Correct vaccine coding (CVX codes, product + administration pairing)
- Understanding of same-day well + sick visit documentation requirements
- Proper billing of developmental/behavioral screenings
95-97% first-pass acceptance rate vs 75-80% industry average
Vaccine Billing Mastery
We correctly code:
- Vaccine product codes (90476-90759 series)
- Administration codes (90460-90461, 90471-90474)
- Counseling vs non-counseling administration
- VFC (Vaccines for Children) program compliance
- State immunization registry reporting
→ Zero vaccine claim denials due to coding errors
Same-Day Visit Optimization
Expert handling of:
- Well-child exam + sick visit on the same day (modifier 25 requirements)
- Preventive + problem-focused E/M documentation separation
- Appropriate diagnosis code linking (preventive vs problem)
- Medical necessity justification for both services
→ 92%+ success rate on same-day visit claims (vs 60-70% industry average)
Developmental & Behavioral Screening Billing
We ensure proper billing for:
- Autism screening (96110)
- Developmental screening (96110)
- Emotional/behavioral screening (96127)
- Depression screening (96127)
- Maternal depression screening (96161)
- Proper age ranges and frequency limits
→ Medical necessity documentation that prevents denials
Newborn Care Revenue Capture
We maximize reimbursement for:
- Hospital newborn visits (99460-99465)
- Circumcision (54150, 54160)
- Lactation support (99401-99404, S9443)
- Newborn hearing screening (92558)
- Jaundice management and phototherapy
- NICU consultation and critical care
→ Average $2,800-$4,200 additional revenue per newborn properly coded
Real-Time Revenue Visibility
- Daily claim submission tracking
- Weekly denial pattern analysis
- Monthly financial performance reports
- Quarterly compliance audits
→ Complete transparency on where every dollar is
Pediatric Services We Master
If you treat it, we bill it correctly—the first time.
Well-Child Visits
- Newborn to 1 year (99381, 99391)
- Ages 1-4 years (99382, 99392)
- Ages 5-11 years (99383, 99393)
- Ages 12-17 years (99384, 99394)
- Ages 18-21 years (99385, 99395)
Immunizations
- All CDC-recommended vaccines (birth through 18 years)
- Vaccine product codes (90XXX)
- Administration codes (counseling vs non-counseling)
- Combination vaccine coding
- VFC program compliance
Sick Visits & Acute Care:
- Minor illness management
- Acute injury evaluation
- Same-day sick + well visits
- After-hours and weekend visits
- Telemedicine visits (99441-99443)
Developmental & Behavioral Services
- Normal newborn hospital care (99460-99462)
- Newborn resuscitation (99465)
- Circumcision (54150, 54160)
- Lactation counseling
- Newborn metabolic screening
- Hearing screening
Newborn Care
- E/M visits (all complexity levels)
- Acne management
- Psoriasis treatment
- Eczema management
- Biologics administration and monitoring
- Isotretinoin (Accutane) management with iPledge
Chronic Disease Management
- Asthma care
- Diabetes management
- ADHD medication management
- Obesity counseling (99401-99404)
Procedures:
- Laceration repair
- Foreign body removal
- Abscess I&D
- Wart removal
- Ear lavage
Real Results
6-Physician Pediatric Group (Ohio)
Florida Case Study
- Before NEO MD
Denial rate on same-day visits
22%
Vaccine claims rejected
18%
Annual revenue loss
$280K
Hours weekly on insurance calls
35+
- After NEO MD
Denial Rate
4.1%
Vaccine claim acceptance
99.8%
Annual revenue recovery
$456K
Hours freed weekly
31
“We had no idea we were losing so much on vaccine coding alone. Neo MD’s pediatric expertise transformed our revenue cycle. Our cash flow is predictable, our staff is happier, and parents aren’t confused by their bills anymore.”
Dr. Jennifer S.
Pediatrician
Performance Benchmarking: Neo MD vs Industry Standard
| Metric | Industry Avg | NEO MD Pediatrics |
|---|---|---|
| Clean Claim Rate | 75–80% | 95–97% |
| Denial Rate | 18–25% | 4–6% |
| Vaccine Coding Accuracy | 82–88% | 99%+ |
| Same-Day Visit Success | 60–70% | 92%+ |
| Days to Payment | 38–52 days | 24–31 days |
| Collection Rate | 92–94% | 97–99% |
Our Process: Revenue Acceleration in 90 Days
Complete analysis of your billing data:
We analyze denial patterns with a focus on same-day visits and vaccine services, identify undercoding opportunities in preventive visits and newborn care, assess vaccine billing accuracy, and uncover documentation gaps. You receive a detailed report that clearly shows where revenue is leaking and the exact recovery potential for each area.
Our process ensures zero disruption to cash flow or patient care while payer enrollment and credentialing are fully verified. Staff receive targeted training on documentation requirements, and EMR integration is completed seamlessly. As a result, most practices submit their first clean claims within 10–12 business days.
Practices see an immediate improvement in claim acceptance rates as previously denied claims are reworked and successfully recovered. Vaccine coding accuracy improves to 99%+, same-day visit denials are eliminated, and cash flow improvements become visible within the first month. On average, practices achieve a 21–26% revenue increase by day 90.
We provide bi-weekly performance reports, conduct monthly strategy calls, and perform quarterly compliance audits to ensure sustained accuracy. Annual coding updates—including CPT, ICD-10, and vaccine-related changes—keep your practice fully compliant. The long-term impact is consistent, year-over-year revenue growth as documentation and coding accuracy continue to improve.
Critical Compliance Issues We Handle
Pediatric practices face unique compliance challenges. We protect you by managing:
Age-based code accuracy
prevents auto-denials for wrong age range
Vaccine billing compliance
VFC program, state registries, proper documentation
Same-day visit documentation standards
modifier 25 medical necessity
Developmental screening frequency limits
payer-specific rules
Medicaid/CHIP billing requirements
often 50%+ of pediatric revenue
Medical necessity
for behavioral health screenings
Preventive vs problem
diagnosis code separation
Newborn hospital care coding rules
place of service, initial vs subsequent
We keep you compliant, paid, and audit-ready.
Free Download
Pediatric Denial Prevention Checklist
The exact pre-submission checklist our coders use for 95%+ clean claim rates.
Age-based preventive code selector (birth-21 years)
Same-day well + sick visit documentation guide
Developmental screening billing rules by payer
Vaccine coding matrix (product + administration pairing)
Modifier 25 medical necessity templates
Newborn care billing checklist
Used by 180+ pediatric practices. Worth $1,800. Yours free.
Frequently Asked Questions
10–14 days with zero claim disruption. We coordinate everything with your current billing company.
Yes. We're experts in Medicaid/CHIP billing requirements, which often represent 50-70% of pediatric revenue.
We handle all VFC documentation requirements and ensure proper coding for publicly-funded vs private-pay vaccines.
6-8% of collections (standard), but our clients average 21-26% revenue increase, netting 13-20% more than today.
No. We integrate with all major pediatric EMRs, including eClinicalWorks, Athenahealth, Epic, Cerner, NextGen, and PCC.
That's our specialty. 92%+ success rate on these claims vs 60-70% industry average.
Yes. We provide clear, parent-friendly statements and handle patient responsibility follow-up with empathy.
- Financial Attrition Warning
Stop Losing $10K–$30k Every Month
Every month you delay is another month of compounded clinical leakage.
Same-day visit denials leave money on the table
Vaccine claims rejected for preventable coding errors
Preventive visits undercoded and underpaid
Staff overwhelmed with insurance appeals
Parents are confused and frustrated by billing issues
Partner with Neo MD
Operational Performance Protocol
Staff focuses
on kids, not insurance companies
Two Ways to Get Started
Option 1
Free Revenue Analysis
No obligation. No sales pitch. Just data.
We’ll show you:
- Exactly how much revenue you're losing
- Which visit types are being denied the most
- Vaccine coding accuracy assessment
- How much can you recover
Option 2
Talk to a Specialist
15-minute consultation. Zero pressure.
We’ll discuss:
- Your current billing challenges
- Same-day visit denial patterns
- Vaccine billing accuracy
- Whether Neo MD is the right fit
Or call us directly:
- (929) 502-3636
Monday-Friday, 8 am-5 pm EST
The Cost of Waiting
If you’re a pediatric practice collecting $1.8M annually and losing 18% to billing inefficiencies:
$324,000
Per year in lost revenue
$1.62M
Over 5 years
$27,000
Lost every month you wait
That’s another provider salary, expanded office space, upgraded equipment, or early retirement.
The question isn’t “Should I switch?”
The question is: “How much more am I willing to lose?”
Neo MD Inc. | Pediatric Medical Billing Specialists
Maximizing revenue for pediatric practices nationwide since [YEAR]
Trusted by 140+ dermatology practices across all 50 states