Vaccine admin coding rebuilt — 23% revenue lift on shots.
A small pediatric practice was under-coding vaccine administration — leaving real money on every well-child visit. Rebuilding their 90460/90461 workflow lifted vaccine revenue 23%.
+ 23%
Vaccine revenue
+ 23%
Vaccine revenue
+ $ 4.1k
Avg. monthly lift
7.9% → 5.1%
Denial rate
100%
Per-component capture
The challenge
Riverbend was billing a single admin code per visit instead of coding per-component with 90460/90461. Across a busy vaccine schedule, that adds up to thousands of dollars a month left uncollected.
What we did
- Rebuilt vaccine administration coding to capture every component with 90460/90461.
- Mapped Utah Medicaid and VFC program rules into the workflow.
- Trained the nursing staff on documentation that supports per-component billing.
- Added a monthly vaccine-revenue check to the reporting dashboard.
"We had no idea how much we were leaving on the table with vaccine coding. The monthly lift more than covers what we pay ClearClaim."
SN
Dr. Sarah Ng
Owner, Riverbend Pediatrics
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Stop fighting your payers.
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