- Pediatric Coding & RCM
- Eligibility & Claim Verification
- AR & Denial Management
Comprehensive Billing & RCM for Pediatric Practices
From newborn care and vaccinations to adolescent medicine, chronic condition management and specialty referrals — pediatric practices face unique billing complexities. Valiant Lifecare manages the full cycle: eligibility verification, prior-authorization handling, coding, claim submission, payment posting, denial follow-up and AR resolution — helping practices improve cash flow, reduce denials, and focus on patient care.
Our Pediatric RCM Services
Eligibility Verification & Prior Authorization
Check insurance, confirm coverage for age-specific services, vaccines, developmental screenings and pre-authorizations to prevent denials.
Pediatric Coding (ICD-10 / CPT / HCPCS)
Accurate coding for well-child visits, immunizations, developmental assessments, preventive care, chronic care, and specialty therapies aligned with pediatric guidelines.
Claims Submission & Follow-up
Prompt claims filing, payer tracking, and follow-up to ensure timely adjudication and payment.
Accounts Receivable & Denial Management
Active monitoring of outstanding claims, denial root-cause analysis, correction, and resubmission to maximize collections.
Vaccination & Preventive Care Billing
Special handling of immunization codes, preventive medicine E/M codes, combo visits (sick + well), and payer-specific requirements.
Specialty & Multi-Specialty Support
Support for pediatric sub-specialties: cardiology, endocrinology, neurology, neonatology, chronic disease management — with tailored coding and claim handling.
Chart & Documentation Review
Quality checks, documentation audits and clinical validation to ensure billing support and audit-readiness.
Reporting & Analytics
Detailed metrics on claim cycles, denial rates, vaccine billing, collections performance and revenue per provider for better financial visibility.
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Our Pediatric RCM Workflow
We follow a structured, pediatric-optimized billing process to ensure accuracy, compliance, and timely reimbursement while minimizing workload on your clinical and administrative staff.
Patient Intake & Eligibility Check
Gather patient demographics, insurance & benefit details — including immunization coverage and preventive care eligibility.
Documentation & Coding Preparation
Capture visit notes, immunization records, growth metrics, developmental assessments, and apply correct age-appropriate codes.
Claim Submission
Submit claims electronically or via payer-specific formats, ensuring all documentation and modifiers comply with pediatric insurance rules.
Payment Posting & Reconciliation
Post remittances, co-pays, patient payments; reconcile adjustments and denials.
Denial Handling & Appeals
Analyze denials, correct coding or documentation issues, resubmit, or appeal to recover revenue.
Reporting & Continuous Optimization
Deliver financial and operational reports; identify trends (e.g. high denial codes, recurring vaccine claim issues) and recommend workflow improvements.
Speak With an Expert
Improve Your Operational Outcomes. Connect with us today for a no-charge in-depth Consultation before we begin optimizing your operations.
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