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Pediatrics · Southern California

Medical billing built for pediatric practices

Pediatric billing lives on high volumes of well-child visits, immunizations, and Medi-Cal managed care, where small coding and administration errors multiply quickly. Quantix Health builds vaccine, EPSDT, and sick-visit workflows so every covered service is captured and reconciled against each plan's rules.

  • Immunization administration coded separately from vaccine product, with VFC vs. purchased-stock tracking
  • Well-child and EPSDT visits mapped to age-appropriate CPT and screening codes
  • Sick visit plus well-child same-day encounters split with modifier 25 support
Why pediatric practices choose us

Specialty expertise, not generic billing

Vaccine and VFC accuracy

We separate administration from product, track VFC versus privately purchased stock, and code counseling so immunization revenue is complete and compliant.

Well-child and EPSDT

Preventive visits are coded by age with required developmental, vision, and behavioral screenings so Medi-Cal EPSDT components are billed, not lost.

Same-day sick visits

When a problem visit occurs alongside a well-child exam, we document and modifier the encounter so both are appropriately reimbursed.

Medi-Cal managed care

We manage plan-specific eligibility, PCP assignment, and encounter reporting across Southern California Medi-Cal managed care plans.

Common billing challenges

Where pediatric practices lose revenue

These are the specialty-specific leaks we watch for — and fix at the root.

  • Immunization administration codes (90460/90461) undercounted for multi-component vaccines and counseling
  • VFC versus privately purchased vaccine stock billed incorrectly, causing recoupments
  • Well-child plus sick visit denials when modifier 25 documentation is insufficient
  • EPSDT screening components (developmental, vision, hearing, behavioral) not captured for Medi-Cal reimbursement
  • Newborn and inpatient-to-outpatient transition coding and eligibility mismatches
  • Medi-Cal managed care PCP assignment and eligibility errors driving front-end rejections
FAQ

Common questions

How do you handle VFC vaccine billing?

We track VFC-eligible versus privately purchased stock, bill the administration codes separately from the product, and code counseling components so immunization services are captured accurately and stay compliant with program rules.

Can you bill a sick visit and a well-child exam on the same day?

When documentation supports a distinct problem-oriented service, we code both and apply modifier 25 appropriately, which reduces the same-day denials pediatric practices see most often.

Do you work with Medi-Cal managed care plans?

Yes. We manage eligibility, PCP assignment, EPSDT components, and encounter reporting across Southern California Medi-Cal managed care plans such as IEHP and Molina.

Let's strengthen your pediatrics revenue

Book a free, no-obligation consultation. We'll review your billing and show you the opportunity — no pressure.