A pediatric schedule mixes well-child checks, sick visits, and vaccine administration, often for children covered by Medicaid or CHIP. Each of those follows its own payer rules. Taiga works with pediatric practices and handles the claims, denials, and family statements behind that schedule.
Book a demoMost pediatric revenue comes from a few visit types repeated thousands of times a year. Small errors in each one add up.
VFC providers cannot charge for the vaccine itself when the child is eligible. They can charge an administration fee for each vaccine, plus an office visit fee when other services happen at the same appointment. Privately purchased stock for commercially insured children is billed differently, so the claim has to reflect which stock each dose came from.
For children on Medicaid, well-child visits fall under EPSDT, which includes a health and developmental history, exams, screenings, and referrals. States run it directly or through managed care plans, so billing details can differ between a state program and each plan.
A child who comes in for a checkup with an ear infection may need both a preventive visit and a problem visit on one claim. Payers differ on whether they pay both and what documentation they expect, which makes this a common denial point.
Clinicians and the front desk stay focused on kids and families. Billing work moves to Taiga with a clear line between the two.
Visit notes, vaccine documentation, and VFC inventory records stay with your clinical team under your state immunization program rules. Your physicians approve the codes Taiga drafts before any claim goes out.
Code drafts from each visit note, eligibility checks, claim scrubbing and submission, every denial and appeal, and statements and follow-up with families on any balance.
Which payers pay a same-day sick and well visit as two services, and how administration-only VFC lines should appear for each Medicaid plan. Settle these with de-identified examples during onboarding.
Bring a de-identified sample of recent claims and remittances. Do not send patient details through the booking form.
Estimate the share of Medicaid, CHIP, managed care, and commercial patients, and name the plans that cause the most rework today.
Explain how VFC and privately purchased doses are separated in your EHR and on the claim.
List open denials and aging balances by payer, and say whether Taiga should take over that backlog or run in parallel at first.
A good fit for a pediatric group that wants physician-approved coding and full follow-through on every claim, including the small vaccine administration and screening lines that often get written off.
VFC fee caps, Medicaid rates, and screening rules are set by your state and its plans. Taiga follows those rules on your claims; it does not set them or decide coverage.
Not for the vaccine itself. VFC providers can charge an administration fee for each vaccine and an office visit fee when other services are provided, within the limits your state program and Medicaid set.
Yes. Pediatrics is one of the specialties Taiga works with. Taiga drafts codes from your notes, your physicians approve them, and Taiga submits and follows every claim.
Yes. Taiga works every denial and appeal, including small-dollar ones, so low-value lines are not left to age out.
No. Taiga works alongside the EHR you already use, so your clinical workflow and vaccine records stay where they are.
Bring your payer mix, vaccine workflow, and open A/R. Taiga will walk through onboarding, which takes about two weeks to the first claim.
System guides show possible billing handoffs, not proven specialty compatibility.