Pediatric billing has its own rules. So do pediatric denials.
Vaccine administration, well-child visits, and therapy referrals get denied for reasons specific to pediatric coding and payer policy. We build appeals around what pediatric practices actually see.
Denials we see most in pediatrics.
Every specialty has its own denial patterns. Here's what we typically find in pediatrics practices.
Vaccine administration coding
Vaccine and administration codes billed together are frequently denied or underpaid when payer-specific bundling rules aren't matched exactly.
Well-child visit with sick visit same day
A well-child visit that turns into addressing an acute concern often gets one of the two visits denied as duplicate or bundled.
Therapy session limits
Speech, occupational, and physical therapy referrals hit payer session caps that require documentation to appeal for continued care.
Newborn and NICU billing
Newborn care billed separately from the mother's claim, or NICU level-of-care disputes, are a recurring denial category in pediatrics.
The same done-for-you service, built for your specialty.
We pull your denials
Connected to your billing workflow, reviewed as they come in.
AI drafts, specialists review
Every appeal is cited to payer policy and reviewed by a billing specialist before it's sent.
We handle payer follow-up
Calls and re-submissions your staff doesn't have time for.
You see what's recovered
A simple monthly report on what was appealed and what came back.
See what your pediatrics denials are costing you.
Send us a sample of your recent denials. We'll show you what we'd appeal and what it could recover, free.
Get my free denial audit →Frequently asked questions.
Do you handle therapy session-limit appeals?
Yes, we document medical necessity for continued speech, OT, or PT sessions beyond the payer's initial cap.
Can you help with newborn and NICU billing denials specifically?
Yes, these are billed and denied differently from standard visits, and we handle them as their own category.
What about well-child and sick-visit same-day denials?
We appeal these citing the distinct services provided and correct modifier usage.
Do you work with pediatric primary care and pediatric specialty practices both?
Yes, onboarding is scoped to your practice's specific mix of visit types.