The Only Pediatric-Focused CDI Firm in the Country. Now Part of Enjoin.

Children’s hospitals face reimbursement challenges that adult facilities rarely encounter. The complexity of pediatric care, combined with APR-DRG severity requirements and age-specific documentation standards, creates revenue integrity risks that general CDI programs often miss.

Unlike adult models, pediatric reimbursement demands documentation that captures how multiple chronic conditions interact, how developmental factors influence care, and how clinical details specific to infants and children affect outcomes. When documentation doesn’t tell the complete clinical story, hospitals aren’t compensated for the true intensity of care they provide, and that adds up quickly.

For children’s hospitals operating on tight margins while serving high-acuity populations, getting pediatric documentation right isn’t just about compliance. It’s about financial sustainability.

What Makes Pediatric Revenue Cycle Different

• APR-DRG Severity Capture: Four-tier severity levels mean that documentation must show how conditions affect each other, not just list diagnoses. Age-specific factors in pediatrics require specialized clinical knowledge to document correctly.
• High-Acuity NICU Populations: Premature babies need documentation that establishes both severity of illness and risk of mortality: metrics that directly impact both reimbursement and quality rankings.
• Status Determination Complexity: Deciding whether a pediatric patient should be admitted as inpatient or placed under observation has unique clinical and financial implications. Getting status right prevents denials and ensures appropriate payment for the level of care provided.
• Chronic Condition Management: Many pediatric patients live with complex, ongoing conditions that require careful documentation at every hospital encounter. Capturing this complexity helps reduce preventable readmissions.

The Enjoin + PRG Solution: Physician-Led Pediatric Hospital Revenue Cycle & CDI Solutions

Through the acquisition of Pediatric Resource Group, Enjoin is the only healthcare consulting firm in the country exclusively focused on pediatric revenue cycle services. Founded by Dr. Ara Balkian, who built the CDI and Physician Advisor programs at Children’s Hospital Los Angeles, PRG brings credibility that only comes from real-world pediatric leadership experience.

Why Physician-Led Expertise Matters

Our team of board-certified pediatricians, neonatologists, and pediatric specialists doesn’t just consult; they actively practice and lead clinical programs at many of the nation’s top children’s hospitals. They understand the clinical reality of caring for medically fragile children, and they know how to translate that complexity into compliant, defensible documentation that accurately reflects patient acuity.

Pediatric-Specific Services

• Pre-Bill and Post-Bill CDI Reviews: Concurrent reviews by pediatric physicians who understand APR-DRG requirements, ensuring documentation captures severity before claims go out the door
• Physician Advisor Programs: Design and implementation of pediatric-focused physician advisor services for status determination, peer-to-peer reviews, and proactive denials prevention
• CDI Program Development: Build or expand pediatric CDI capabilities with education tailored to children’s hospital workflows, clinical definitions, and APR-DRG optimization
• Utilization Review Support: Length-of-stay management, discharge planning support, and coordination between Physician Advisors and UR teams

Partner With the Only Pediatric-Focused CDI Experts in the Countr

Children’s hospitals deserve revenue cycle partners who understand the unique complexity of pediatric care. Enjoin, powered by Pediatric Resource Group, delivers physician-led CDI solutions built specifically for APR-DRG environments.