Re: [Practiceimprovement1) veterinary medical billing on vaccines

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Dog vaccine companies don't have the gall to charge what the vaccine companies are charging us. Rabies Vaccines run around $2.00 to $3.00 each, and the highest price ones are the new vaccines at around $17.00 for this generation multi vaccine, and these are usually prices percentage wise lower. What happens is, the low price older vaccines are priced at around four times the cost because otherwise it is not worth while to carry them. I think the West Nile vaccine was around $17 the last time I bought it, and it usually went for twice the purchase price, plus an office call, plus time (since one usually drove to the farm to give this vaccine) which would mean it would come around $40.00 plus the office call at $120.00 an hour: Maybe only a 15 minute call if they have the animal in a

stall....if you have to spend an hour catching it the cost is more, reasonably enough; that makes it attractive for the owner to have everything ready for you when you show up. And then so much a mile for the drive out... It is cheaper per animal if more animals are present at the same time, so people organize vaccine clinics in riding clubs for example.

You can see the visit charge is based on different things than ours are.

Joanne Holland DVM/MD

Subject: Re: Avoiding vaccine errors, about the medical mistake.To: Date: Friday, August 29, 2008, 8:06 PM

" re·im·burse [ r & #63485; im búrss ] (past and past participle re·im·bursed, present participle re·im·burs·ing, 3rd person present singular re·im·burs·es) transitive verb Definition: pay back money to somebody: to pay somebody back money spent for an official or approved reason or taken as a loan, or give somebody money as compensation for loss or damage"I guess I was using the wrong meaning for reimbursement when theclient pays cash, I guess it's not considred "reimbursement" vs when a 3rd party like an insurance co. pays usus?Anyway, what you are saying is that for dogs and cats, you can mark upthe cost of the vaccines by a factor of 4 times what they cost you? Plus charge for an office visit? That's quite attractive, from the providers viewpoint comparedto practicing medicine on humans. I was checking on Herpes Zoster vaccine and I think

from Henry Schein it was $1700+ for a 10 dose vial and it's on Medicare Part D which has some really complicated scheme for getting paid, apparantly the patient has to pay you out of pocket, but you can only charge them what the vaccine costs you plus maybe a small injection admin fee and the patient somehow get reimbursed from Medicare Part D? Weird. Along with the Part D doughnut hole, one of the most bizarre things the've come up with to make things needlesly complicated.> > > > > >> > > >

> >> Greetings,> > > > > >>> > > > > >> being one year into my micropractice, I just made my first > negative> > > > > >> experience, which I attribute to being solo-solo.> > > > > >>> > > > > >> Two parents brought their 2 months-old child in for its first,> > > > > >> selective vaccination. They had carefully researched the > vaccination> > > > > >> market and its problems (aluminum content etc.) and had chosen > a> > > > > >> specific brand of DTaP for their child. This happened to be > the one I> > > > > >> had been given by the health department for my patients. Great.> > > > > >>> > > > >

>> Well, I am solo-solo and quite new to this vaccination deal. > While> > > > > >> chatting with the parents and answering questions about their > child's> > > > > >> development, I prepared the shot - and inadvertently drew up > Pediarix> > > > > >> (=Dtap, Hib, and Hep and not the Daptacel (=Dtap). I guess, > both> > > > > >> start with "Tetanus, diphteriae, and Pertussis". Pediarix has > a much> > > > > >> higher Aluminum content. Now, this is the one the parents> > > > specifically> > > > > >> did NOT want to give to their child.> > > > > >>> > > > > >> I attribute this medical mistake to the fact that I carry so > many> >

> > hats> > > > > >> at once here in my little micropractice: front desk person, > nurse,> > > > > >> doctor, janitor, and everything else. I was simply distracted > and> > > > > >> missed this one despite double checking.> > > > > >>> > > > > >> I have several choices now:> > > > > >> 1. Design a different workflow that allows me a few minutes of > quiet> > > > > >> time to double check without having to socialize with parents > at the> > > > > >> same time> > > > > >> 2. Get rid at least of Pediarix> > > > > >> 3. Stop doing vaccinations since this is the most error-prone> > > > > >>

procedure in my practice> > > > > >> 4. Keep doing vaccinations and get more experience. I would > assume> > > > > >> that I would not mix up Dtap and Pediarix any more> > > > > >>> > > > > >> I was wondering whether anyone else has had a similar > experience,> > > > > >> thoughts, or any words of wisdom (which I happen to need right > now).> > > > > >>> > > > > >> Thanks, Marius> > > > > >>> > > > > >> > > > > > >>> > > > > >> > > > > >> > > > > >> > > > > > --> > > > > > If you are a patient please allow up to 12

hours for a reply by > email/> > > > > > please note the new email address.> > > > > > Remember that e-mail may not be entirely secure/> > > > > > MD> > > > > > > > > > > > > > > > > > ph fax > > > > > >> > > > > >> > > > > > > > > > > > > > > -- > > > > > If you are a patient please allow up to 12 hours for a reply by > email/> > > > > please note the new email address.> > > > > Remember that e-mail may not be entirely secure/> > > > > MD> > > > > 115 Mt Blue

Circle> > > > > > > > > > ph fax > > > > >> >>