Home Product Billing & Revenue
Billing & Revenue

A dedicated billing team fighting for every cent.
Under your contracts, into your bank.

A dedicated billing team focused solely on vaccine billing. Bills under your NPI and Tax ID. All money goes to your bank first. If insurance doesn't pay, Canid absorbs the loss. Weekly invoices on confirmed-paid claims only.

In-house

dedicated vaccine billers

100%

admin fees kept by you

$0

billing fees to your practice

3-4

weeks from claim to payment

The financial reality

Most practices think they profit $42 per vaccine. The real number is closer to $12.

Between insurance issues, billing fees, and waste, most practices lose a significant share of vaccine revenue before they see a dollar of profit. Most run ~12% margins. The AAP says you need 17–28% just to break even.

Without Canid: Private Vaccine (Varivax + BCBS)

Admin fee+$28
Inventory reimbursement+$155
Vaccine cost-$141
Billing fees (6%)-$11
Waste (2%)-$3
Underpayments (5%)-$9
Staff time-$7
Actual profit $12
2x+ improvement

With Canid: Same Vaccine, Same Insurer

Admin fee (you keep 100%)+$28
Vaccine costCanid pays
BillingCanid handles
WasteCanid covers
UnderpaymentsCanid absorbs
Staff timeA fraction of the time
Your profit $28+

For VFC vaccines, the impact is even more dramatic. See the full VFC breakdown →

Real-world billing losses we see every day

ProQuad in Texas

A Texas practice was reimbursed only 1/3 of the cost for ProQuad, actively losing money on every dose administered. With Canid, the practice would keep the full admin fee while Canid absorbs the inventory risk.

Out-of-Network Surprise

Patient's insurance was active, but the practice wasn't the in-network PCP. The claim denied and the practice had to eat the full vaccine cost. Canid's VFC borrowing safety net and eligibility checks catch these before they become losses.

Secondary Insurance (Medicare + Veteran)

Medicare patients with veteran or military benefits (TRICARE) often have secondary insurance that practices don't bill. The practice eats the cost on each dose. Canid's billing team chases secondary insurance on every applicable claim.

EMR Transition Billing Error

One practice discovered their RCM company wasn't collecting on Aetna at all due to a filing error during an EMR transition. Months of revenue just gone. With Canid, vaccine claims bypass your RCM entirely, eliminating this kind of gap.

How billing works

The 7-step claim lifecycle. Fully automated.

From the moment you scan a vaccine to the moment insurance pays, every step is handled by Canid's billing engine and team. Here's exactly what happens.

1

Scan triggers the claim

When your MA scans a vaccine barcode, Canid instantly captures the patient, vaccine, lot number, insurance, and provider information. This data becomes the foundation of the claim. No manual data entry, no errors.

2

Auto-match with insurance plan rules

The billing engine matches the claim data against a rules database covering every combination of insurer, plan, and state. It knows which codes, modifiers, and billing strategies work for each payer.

3

Auto-assigns CPT/NDC/modifiers per insurer + plan + state

The system automatically assigns the correct CPT codes, NDC codes (when required), and modifiers for maximum reimbursement. This includes specialized codes: COVID (90480), RSV (96380), intranasal flu (90473), Medicare Part B G-codes, and pediatric counseling codes (90460/90461).

4

Same-day grace period for edits

After scanning, your team has until end of day to make corrections. Changed the site of administration? Different prescriber? All editable. Claims auto-submit the next business day, giving your team time to get everything right.

5

Waystar clearinghouse submission

Claims are submitted through Waystar, a major healthcare clearinghouse, with multiple validation layers before they reach the payer. This catches formatting errors, missing fields, and payer-specific requirements before they can cause a denial.

6

Insurance pays in weeks 3-4

Insurance processes and pays the claim. The money goes directly to your practice's bank account. Not to Canid. Not to a third party. To you, under your contracts, under your NPI and Tax ID.

7

Weekly Canid invoice for inventory portion only

Canid sends a weekly invoice for the inventory portion of confirmed-paid claims only. If a claim hasn't been confirmed as paid (via EOB or phone verification), Canid never invoices it. If insurance doesn't pay at all, Canid absorbs the loss entirely.

Specialized codes handled automatically

90480

COVID administration

96380

RSV (subcutaneous)

90473

Intranasal FluMist

G-codes

Medicare Part B

90460

Pediatric counseling (first)

90461

Pediatric counseling (add-on)

Under your contracts

Your NPI. Your Tax ID. Your money.

Unlike other vaccine management platforms that bill under their own contracts, Canid bills under your practice's NPI and Tax ID. This matters for three critical reasons.

Full transparency

You have complete visibility into every claim, every payment, every denial. Check your insurance portal anytime. Admin fees are visible right there.

Industry compliance

Billing under your own identifiers keeps you in compliance with industry regulations. No middleman contracts. No partner-based billing surprises.

VFC requirement

VFC admin fees must go through the clinic's Tax ID. Any platform that bills under its own contracts can't handle VFC properly.

Canid's revenue model: aligned incentives

Canid earns the margin between the vaccine purchase cost and the inventory reimbursement from insurance. If insurance doesn't pay, Canid loses $200+ per dose. That's why our billing team fights for every cent on every claim.

Example: Single Varivax dose

Insurance reimburses inventory$155
Canid's purchase cost-$141
Canid's margin$14
Practice keeps 100% of admin fees. Always.
Money goes to your bank first. Canid invoices weekly on confirmed-paid claims.
If insurance doesn't pay, Canid absorbs the full cost.

Enterprise pricing for high-volume practices

For larger organizations, Canid offers a revenue share model on inventory reimbursements. Start with an estimated rate, review actual results after 3 months, and adjust if needed. One guarantee: always more profitable than managing vaccines on your own.

Dashboard & transparency

Every claim, every dollar, every detail visible.

Five dashboard views give you complete visibility into your vaccine billing. No black boxes. No waiting for statements. Real-time transparency into where your money is.

Billing Dashboard

Your financial command center

See monthly recovered amounts broken down by inventory and admin codes. Track total recovered revenue split by private vs VFC. Monitor percentage recovered with pending distribution. See admin time saved at a glance.

$47K

Recovered MTD

94%

Collection rate

$3.2K

Pending

42 hrs

Admin saved

Canid | Billing Claims CANID
1
Claims dashboard with status filters
2
Claim detail & status sidebar
Incoming Payments

Know what's coming before it hits your bank

See which claims have been approved and paid by insurance before the money arrives in your bank account. No more guessing when or how much you'll receive.

Approved claims listed before deposit
Amounts verified via EOB
Cash flow forecasting
Claims Filter

Find any claim in seconds

Search by date of service, patient name, insurance carrier, claim status, inventory type, or invoice date. Create a support ticket from any claim. Access EOBs with a single click.

Canid | Billing Claims CANID
1
Claims filtered by In Progress status
2
Claim lifecycle tracking
Balance Movements

Every dollar accounted for

Complete record of all account activity: invoices issued, debits processed, credits applied. Full audit trail for your bookkeeping. No unexplained charges. No mysterious line items.

Invoices
Debits
Credits
Invoices

Downloadable, verifiable PDFs

Every invoice includes total amounts, applied charges, and direct links to the claims and EOBs with check date and number. Download as PDF for your records.

Canid | Billing CANID
1
Weekly invoice history
2
Payment status at a glance
3
Tied to confirmed-paid claims
Built-in Ticketing

Have a question about a claim? Click, type, done.

From any patient's billing record, click "more info," then "new ticket." Canid's support team replies within the day. Every ticket is tracked in the system, so nothing falls through the cracks.

New Ticket
Why was claim #4821 denied?
Replied in 3 hours
Denial & recovery

Four specialized teams. One mission: get you paid.

When a claim doesn't pay the first time, most practices write it off. Canid has $200+ on the line per dose, so our billing team fights through every denial, every underpayment, every coverage gap.

Corrections Team

Configuration errors

Catches and fixes configuration errors: wrong CPT code assigned, missing modifier, incorrect NDC code. These are the simplest denials to fix but the easiest to miss when you're handling thousands of claims.

Resubmission Team

Network issues

Handles network-level issues like out-of-network prescribers. Instead of writing off the claim, this team adjusts the billing strategy and resubmits with a different approach tailored to the specific payer.

Appeals Team

Payer processing errors

Fights payer processing errors through every available channel: insurance portals, phone calls, fax submissions. When a payer incorrectly denies a valid claim, this team does not stop until it's resolved.

Review Team

Coverage gaps (3-month monitoring)

Monitors patients with coverage gaps for up to 3 months. Covers lapsed coverage, grace periods, suspended coverage, and retroactively activated coverage (common with newborns). If insurance truly doesn't pay after monitoring, Canid absorbs the loss.

Underpayment "needling"

Most practices ignore $5-$20 underpayments because it's not worth the staff time. Canid chases every single one. Across hundreds of claims per month, these small shortfalls add up to thousands in recovered revenue per year.

Secondary insurance billing

Medicare patients with veteran or TRICARE benefits have secondary insurance that most practices never bill. Canid's billing team identifies these cases and pursues secondary insurance on every applicable claim. Your practice never manages any of this.

Canid | Denial Tracking CANID
1
Anything with issues you can see at any point
2
Denials are reviewed and fixed automatically
State variability

Same insurer, different rules by state.

This is one of the most overlooked sources of billing errors. The same insurance carrier can have completely different rules depending on which state you're in. What works in Texas will cause overpayments in New York.

Canid auto-configures at three levels:

1 State-level rules
2 Insurer-level rules
3 Plan-level rules
TX

Texas

VFC insurances pay admin fees tied to inventory codes with specific amounts. This is the standard approach in Texas, and billing systems must be configured to submit claims this way.

NY

New York

Submitting those same Texas amounts in New York causes overpayments, which then trigger clawbacks and audits. Different state, same insurer, completely opposite result. Also one of the highest third-party payer delay states.

NJ TN

New Jersey & Tennessee

No VFC borrowing allowed. If a patient turns out to be VFC-eligible after receiving a private dose, you cannot retroactively swap in these states. Canid's system enforces this rule before the scan, preventing compliance violations.

GA

Georgia

Requires the EP modifier instead of SL for VFC claims. Using the wrong modifier leads to automatic denials. Canid's billing engine knows which modifier to apply based on the state before the claim ever leaves the system.

CA IL NY

California, Illinois & New York

High third-party payer concentrations causing significant delays in reimbursement. Canid's billing team has strategies specific to these states to accelerate payments and follow up more aggressively on slow-paying payers.

Advanced capabilities

The billing problems nobody tells you about until they cost you.

New vaccine / seasonal CPT lag

When new vaccines launch, insurers lag on updating their CPT code databases. Claims get denied. Canid proactively identifies these gaps, defines the billing and appeals strategy, and handles the back-and-forth until the workflow stabilizes. Same approach for seasonal flu, COVID, and RSV modifier changes.

Prior authorizations (behind the scenes)

Some vaccines require prior authorization from insurance before they can be billed. Canid handles this completely behind the scenes. Your team never knows it happened, and the patient never gets a surprise bill.

Quarterly audits for every practice

Internal quarterly audits review claim status and distribution, private vs VFC mix, stuck or delayed claims, and borrowing patterns. Identifies missing portal access, configuration improvements, and misclassified VFC plans. Results in a collaborative action plan with your team.

Works alongside your billing company

Vaccine payments appear in your ERA inside your EMR. Two approaches: the "impossibles bucket" (set aside Canid payments so your billing company doesn't apply them elsewhere) or full reconciliation push to your EMR (beta for Office Practicum). Coordinated during onboarding.

Modifier 25 guidance

When vaccines are given on the same day as a well-visit, your practice's billing team needs to add Modifier 25 to the well-visit claim. This prevents bundling denials. Canid provides guidance during onboarding and flags issues when detected.

$20-24K saved/year

RCM savings: vaccines bypass your biller

Many practices pay 4-6% on all reimbursements to their RCM company, including vaccine claims. For a 4-provider practice doing $500-600K in annual vaccine revenue, that's $20-24K per year going to your biller for work Canid handles at no cost. With Canid, vaccine claims bypass your RCM entirely.

Canid | Quarterly Audit CANID
1
Revenue recovery breakdown
2
Patient eligibility split
3
Most claims paid right away, with a few still in progress
Patient-first commitment

Patients never pay. Period.

This is a core principle, not just a policy. Canid never bills patients directly. Pediatric patients never pay out of pocket for vaccines. This protects your practice's reputation and keeps families coming back.

Never bills patients directly

No surprise vaccine bills to parents. Ever.

Never charges kids for vaccines

Pediatric patients never pay out of pocket.

Dedicated COB team

Coordination of benefits resolved with minimal practice or patient involvement.

Patient contact as absolute last resort

Only by trained specialists, only when every other avenue is exhausted.

Self-pay / wholesale for uninsured

Wholesale pricing available for uninsured parents who want to pay out of pocket.

Canid absorbs unrecoverable claims

If insurance truly doesn't pay, Canid absorbs the loss. Not the practice, not the patient.

"I don't know how you guys do it in billing."

MV

Marla Voos

Pinery Pediatrics — Colorado | Customer since Jan 2026

Related features

Billing is just one piece. Explore the full platform.

Get started

Ready to stop losing money on every vaccine?

Book a demo and we'll walk through the billing dashboard using your specific EMR and payer mix. Or calculate your savings right now.

17

States

Growing

Live clinics

Dedicated

Dedicated billers

Nationwide

Team members

Trusted by pediatric practices nationwide

Celebration Pediatrics Pediatric Associates Prof, LLC Calvary Medical Clinic