Re: Vaccine costs

[Guest guest]

I see both kids and adults, but not so many babies. I feel like they come in waves and my current wave is almost 2 now. I priced vaccines and was shocked but in my community my patients are not going to the health department for shots if you know what I mean. I ended up buying what I felt were the bare minimum vaccines and spent around a thousand dollars. I bought one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think where everyone else had 10), ppd test solution, adult td, adult hep B. I think there must be something else but can't think of it right now. I figured if I had young kids coming in for well care I could just order what I needed. The rep says he can get the vaccines to me within 48 hours. Obviously I haven't had any expire yet.

[Guest guest]

I see both kids and adults, but not so many babies. I feel like they come in waves and my current wave is almost 2 now. I priced vaccines and was shocked but in my community my patients are not going to the health department for shots if you know what I mean. I ended up buying what I felt were the bare minimum vaccines and spent around a thousand dollars. I bought one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think where everyone else had 10), ppd test solution, adult td, adult hep B. I think there must be something else but can't think of it right now. I figured if I had young kids coming in for well care I could just order what I needed. The rep says he can get the vaccines to me within 48 hours. Obviously I haven't had any expire yet.

[Guest guest]

When I started I bought 10 doses of everything, both adult and pediatric vaccines. The cost was $4500 which shocked me. However I used most of those up within 6 months. Because of the new pediatric vaccine administration codes I have made a significant profit on my vaccines. I am actively trying to increase the size of my baby practice because I enjoy this aspect of practice. Others may get by with fewer doses. I ordered the vaccines from the wholesaler where I got all my medical supplies (GIV). I am thinking it might be slightly cheaper to get them directly from the manufacturer.Larry Lindeman MD How much can I expect to spend to stock a refrigerator with the minimum number of doses of all adult and pediatric vaccines?  I was thinking of avoiding all the pediatric vaccines at start up but I think I will now have to have them within a month or two of opening.   Also, how much vaccine do you all waste due to expiration before you can use it?  Thanks!mkcl6@... wrote: I am certain my carrier knows about the trigger point and the joint injections. The things that were sure to raise my malpractice by thousands were things like leep, circumcision etc... definitely not trigger point.  I'm not sure why your agent would think a trigger point injection is so high risk, I kind of doubt the underwriter would think so. That may be something you would want to ask them if you want to do them.  Yahoo! Autos. Looking for a sweet ride? Get pricing, reviews, & more on new and used cars.

[Guest guest]

When I started I bought 10 doses of everything, both adult and pediatric vaccines. The cost was $4500 which shocked me. However I used most of those up within 6 months. Because of the new pediatric vaccine administration codes I have made a significant profit on my vaccines. I am actively trying to increase the size of my baby practice because I enjoy this aspect of practice. Others may get by with fewer doses. I ordered the vaccines from the wholesaler where I got all my medical supplies (GIV). I am thinking it might be slightly cheaper to get them directly from the manufacturer.Larry Lindeman MD How much can I expect to spend to stock a refrigerator with the minimum number of doses of all adult and pediatric vaccines?  I was thinking of avoiding all the pediatric vaccines at start up but I think I will now have to have them within a month or two of opening.   Also, how much vaccine do you all waste due to expiration before you can use it?  Thanks!mkcl6@... wrote: I am certain my carrier knows about the trigger point and the joint injections. The things that were sure to raise my malpractice by thousands were things like leep, circumcision etc... definitely not trigger point.  I'm not sure why your agent would think a trigger point injection is so high risk, I kind of doubt the underwriter would think so. That may be something you would want to ask them if you want to do them.  Yahoo! Autos. Looking for a sweet ride? Get pricing, reviews, & more on new and used cars.

[Guest guest]

Be careful of the peds vaccines in combo

w/ a smaller volume practice. We lost a lot of money because some expired

before using them (especially Varivax & MMR, which are only given once or

twice). We now send them to the health dept. Also, shots take a LOT

of time to draw up, administer, & document everything.

Re:

Vaccine costs

When I started I bought 10 doses of everything, both

adult and pediatric vaccines. The cost was $4500 which shocked me. However I

used most of those up within 6 months. Because of the new pediatric vaccine

administration codes I have made a significant profit on my vaccines. I am

actively trying to increase the size of my baby practice because I enjoy this

aspect of practice. Others may get by with fewer doses. I ordered the vaccines

from the wholesaler where I got all my medical supplies (GIV). I am thinking it

might be slightly cheaper to get them directly from the manufacturer.

Larry Lindeman MD

How much can I expect to spend to stock a refrigerator

with the minimum number of doses of all adult and pediatric vaccines? I

was thinking of avoiding all the pediatric vaccines at start up but I think I

will now have to have them within a month or two of opening.

Also, how much vaccine do you all waste

due to expiration before you can use it?

Thanks!

mkcl6@... wrote:

I am certain my carrier knows about the trigger point and the

joint injections. The things that were sure to raise my malpractice by

thousands were things like leep, circumcision etc... definitely not trigger

point. I'm not sure why your agent would think a trigger point injection

is so high risk, I kind of doubt the underwriter would think so. That may be

something you would want to ask them if you want to do them.

Yahoo!

Autos. Looking for a sweet ride? Get pricing, reviews, & more on new

and used cars.

[Guest guest]

Be careful of the peds vaccines in combo

w/ a smaller volume practice. We lost a lot of money because some expired

before using them (especially Varivax & MMR, which are only given once or

twice). We now send them to the health dept. Also, shots take a LOT

of time to draw up, administer, & document everything.

Re:

Vaccine costs

When I started I bought 10 doses of everything, both

adult and pediatric vaccines. The cost was $4500 which shocked me. However I

used most of those up within 6 months. Because of the new pediatric vaccine

administration codes I have made a significant profit on my vaccines. I am

actively trying to increase the size of my baby practice because I enjoy this

aspect of practice. Others may get by with fewer doses. I ordered the vaccines

from the wholesaler where I got all my medical supplies (GIV). I am thinking it

might be slightly cheaper to get them directly from the manufacturer.

Larry Lindeman MD

How much can I expect to spend to stock a refrigerator

with the minimum number of doses of all adult and pediatric vaccines? I

was thinking of avoiding all the pediatric vaccines at start up but I think I

will now have to have them within a month or two of opening.

Also, how much vaccine do you all waste

due to expiration before you can use it?

Thanks!

mkcl6@... wrote:

I am certain my carrier knows about the trigger point and the

joint injections. The things that were sure to raise my malpractice by

thousands were things like leep, circumcision etc... definitely not trigger

point. I'm not sure why your agent would think a trigger point injection

is so high risk, I kind of doubt the underwriter would think so. That may be

something you would want to ask them if you want to do them.

Yahoo!

Autos. Looking for a sweet ride? Get pricing, reviews, & more on new

and used cars.

[Guest guest]

I only used 3 Varivax

shots in my first 24 months of practice.

Re:

Vaccine costs

I see

both kids and adults, but not so many babies. I feel like they come in

waves and my current wave is almost 2 now. I priced vaccines and was

shocked but in my community my patients are not going to the health department

for shots if you know what I mean. I ended up buying what I felt were the

bare minimum vaccines and spent around a thousand dollars. I bought

one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think

where everyone else had 10), ppd test solution, adult td, adult hep B. I

think there must be something else but can't think of it right now.

I figured if I had young kids coming in for well care I could just order what I

needed. The rep says he can get the vaccines to me within 48 hours.

Obviously I haven't had any expire yet.

[Guest guest]

I only used 3 Varivax

shots in my first 24 months of practice.

Re:

Vaccine costs

I see

both kids and adults, but not so many babies. I feel like they come in

waves and my current wave is almost 2 now. I priced vaccines and was

shocked but in my community my patients are not going to the health department

for shots if you know what I mean. I ended up buying what I felt were the

bare minimum vaccines and spent around a thousand dollars. I bought

one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think

where everyone else had 10), ppd test solution, adult td, adult hep B. I

think there must be something else but can't think of it right now.

I figured if I had young kids coming in for well care I could just order what I

needed. The rep says he can get the vaccines to me within 48 hours.

Obviously I haven't had any expire yet.

[Guest guest]

I started out not

planning to do vaccines because of the cost.. Then a family for whom I had delivered

one baby during residency and who had followed me to private practice had

another baby (delivered by OB) and they BEGGED me to do the baby’s well care. So I said “Let me see if I can” . I

priced all the vaccines I would need to immunize a child to age 2, and made the

assumption that I would NOT have to throw away unused doses (probably a bad

assumption, but I was really trying to see a way to do this). The cost was going to run about

$1200. Then I called their insurance

and got the allowed amounts on those vaccines. For the 2 years worth of shots that I

was going to have to pay $1200 to buy, they were going to pay me $530. Needless to say, I had to tell the family

that I couldn’t afford to throw away almost $700.

They just had their fourth baby (4 girls!)

and I wish I could be that baby’s doc, but no can do. I do see the kids for sick visits, but

they go to peds for well care.

Annie

Re:

Vaccine costs

I see

both kids and adults, but not so many babies. I feel like they come in

waves and my current wave is almost 2 now. I priced vaccines and was

shocked but in my community my patients are not going to the health department

for shots if you know what I mean. I ended up buying what I felt were the

bare minimum vaccines and spent around a thousand dollars. I bought

one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think

where everyone else had 10), ppd test solution, adult td, adult hep B. I

think there must be something else but can't think of it right now.

I figured if I had young kids coming in for well care I could just order what I

needed. The rep says he can get the vaccines to me within 48 hours.

Obviously I haven't had any expire yet.

[Guest guest]

I have been doing

immunizations since opening (4/03) and I agree you have to be selective with

the insurance companies. I believe I am just about breaking even doing

immunizations (accounting for straight costs and not including admin time

involved). Like everything, there are pros and cons… Immunizations allow

you to have a more vibrant peds practice which I

love, but they are the biggest recurring supply expense I have. I constantly

look at different vendors to try and find the best price (as these change), but

even if you get a great price, they are not a money maker (at least not in this

area). One thing you should do, however, is get a spoilage clause in your business

liability insurance. If the power should go out (as ours did

after Hurricaine Isabel), you don’t want to

lose $1200 worth of immunizations. This is usually not in the

traditional contracts, but will be found in restaurant contracts.

Re:

Vaccine costs

I see

both kids and adults, but not so many babies. I feel like they come in

waves and my current wave is almost 2 now. I priced vaccines and was

shocked but in my community my patients are not going to the health department

for shots if you know what I mean. I ended up buying what I felt were the

bare minimum vaccines and spent around a thousand dollars. I bought

one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think

where everyone else had 10), ppd test solution, adult td, adult hep B. I

think there must be something else but can't think of it right now.

I figured if I had young kids coming in for well care I could just order what I

needed. The rep says he can get the vaccines to me within 48 hours.

Obviously I haven't had any expire yet.

[Guest guest]

In my area I get reimbursed  about my cost for vaccines. If you get reimbursed a lot less, this might be an area that you could negotiate with payors. We tried that a few years ago by showing our actual invoices for vaccines to one payor and got an increase. In our area I'm am getting up to $20 for the 1st administrative fee and $12 for each additional vaccine under the new vaccine administrative codes for children under 8. Make sure that you add this income when trying to decide whether to give vaccines or not. Also if preventive care is a covered benefit I usually get a lot more money for these visits than I do for a sick visit for children. Because of this I find that seeing babies to be both financially and personally rewarding.  Larry LindemanI started out not planning to do vaccines because of the cost..  Then a family for whom I had delivered one baby during residency and who had followed me to private practice had another baby (delivered by OB) and they BEGGED me to do the baby’s well care.  So I said “Let me see if I can” .  I priced all the vaccines I would need to immunize a child to age 2, and made the assumption that I would NOT have to throw away unused doses (probably a bad assumption, but I was really trying to see a way to do this).  The cost was going to run about $1200. Then I called their insurance and got the allowed amounts on those vaccines.  For the 2 years worth of shots that I was going to have to pay $1200 to buy, they were going to pay me $530.  Needless to say, I had to tell the family that I couldn’t afford to throw away almost $700.  They just had their fourth baby (4 girls!) and I wish I could be that baby’s doc, but no can do.  I do see the kids for sick visits, but they go topeds for well care.Annie -----Original Message-----From: [mailto: ] On Behalf Of mkcl6@...Sent: Tuesday, February 14, 2006 7:10 AMTo: Subject: Re: Vaccine costs I see both kids and adults, but not so many babies.  I feel like they come in waves and my current wave is almost 2 now.  I priced vaccines and was shocked but in my community my patients are not going to the health department for shots if you know what I mean.  I ended up buying what I felt were the bare minimum vaccines and spent around  a thousand dollars.  I bought one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think where everyone else had 10), ppd test solution, adult td, adult hep B.  I think there must be something else but  can't think of it right now.  I figured if I had young kids coming in for well care I could just order what I needed. The rep says he can get the vaccines to me within 48 hours.   Obviously I haven't had any expire yet.  

[Guest guest]

My biggest thing was

getting a single (or just a few vials). If I could get all single vials I

would do the shots, but by throwing out just one shot unused I negate any

profits I might have made on the others for much of the year. I don’t

have the time to keep such close tabs on those & am too afraid I would be

losing $$$ on these shots before I ever caught it. We recently threw out

~ 15 vials of Varivax & 6-8 vials of MMR (I had two supplies: one I bought

for private pays & one from VFC [no loss to me on those]).

Re:

Vaccine costs

I see

both kids and adults, but not so many babies. I feel like they come in

waves and my current wave is almost 2 now. I priced vaccines and was

shocked but in my community my patients are not going to the health department

for shots if you know what I mean. I ended up buying what I felt were the

bare minimum vaccines and spent around a thousand dollars. I bought

one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think

where everyone else had 10), ppd test solution, adult td, adult hep B. I

think there must be something else but can't think of it right now.

I figured if I had young kids coming in for well care I could just order what I

needed. The rep says he can get the vaccines to me within 48 hours.

Obviously I haven't had any expire yet.

[Guest guest]

My response in those

cases is: “great, I’d be glad to see the kids for their well child

visits. We do everything except the shots, for that we just have you go

to the health dept around the corner, a quick in and out usually.”

I’m not sure it has to be either/or. You can still do the well

visits w/o personally doing the shots.

Re:

Vaccine costs

I see

both kids and adults, but not so many babies. I feel like they come in

waves and my current wave is almost 2 now. I priced vaccines and was

shocked but in my community my patients are not going to the health department

for shots if you know what I mean. I ended up buying what I felt were the

bare minimum vaccines and spent around a thousand dollars. I bought

one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think

where everyone else had 10), ppd test solution, adult td, adult hep B. I

think there must be something else but can't think of it right now.

I figured if I had young kids coming in for well care I could just order what I

needed. The rep says he can get the vaccines to me within 48 hours.

Obviously I haven't had any expire yet.

[Guest guest]

In New Mexico all vaccines are paid for by a state Vaccines for Children Program. You have to sign up to be a provider and file endless refrigerator temperature charts, but then it's relatively painless. We are reimbursed only for administration costs by the HMOs and Medicaid, but I don't pay out of pocket for pediatric vaccines. In the case of adult vaccines, I've arranged a few times with local pharmacies to order in a specific vaccine, then the patients pick it up for their copay and I administer it. Complicated, but saves me alot out of pocket. Have folks in the states that aren't covered talked to local pediatricians about what they are doing? Seems like they couldn't afford to pay alot out of pocket either, if they're not being reimbursed sufficiently.I have been doing immunizations since opening (4/03) and I agree you have to be selective with the insurance companies. I believe I am just about breaking even doing immunizations (accounting for straight costs and not including admin time involved). Like everything, there are pros and cons… Immunizations allow you to have a more vibrant peds practice which I love, but they are the biggest recurring supply expense I have. I constantly look at different vendors to try and find the best price (as these change), but even if you get a great price, they are not a money maker (at least not in this area). One thing you should do, however, is get a spoilage clause in your business liability insurance. If the power should go out (as ours did after HurricaineIsabel), you don’t want to lose $1200 worth of immunizations. This is usually not in the traditional contracts, but will be found in restaurant contracts.  -----Original Message-----From: [mailto: ] On Behalf Of Annie SkaggsSent: Tuesday, February 14, 2006 10:55 AMTo: Subject: RE: Vaccine costs I started out not planning to do vaccines because of the cost..  Then a family for whom I had delivered one baby during residency and who had followed me to private practice had another baby (delivered by OB) and they BEGGED me to do the baby’s well care.  So I said “Let me see if I can” .  I priced all the vaccines I would need to immunize a child to age 2, and made the assumption that I would NOT have to throw away unused doses (probably a bad assumption, but I was really trying to see a way to do this).  The cost was going to run about $1200.  Then I called their insurance and got the allowed amounts on those vaccines.  For the 2 years worth of shots that I was going to have to pay $1200 to buy, they were going to pay me $530.  Needless to say, I had to tell the family that I couldn’t afford to throw away almost $700.  They just had their fourth baby (4 girls!) and I wish I could be that baby’s doc, but no can do.  I do see the kids for sick visits, but they go to peds for well care.Annie -----Original Message-----From: [mailto: ] On Behalf Of mkcl6@...Sent: Tuesday, February 14, 2006 7:10 AMTo: Subject: Re: Vaccine costs I see both kids and adults, but not so many babies.  I feel like they come in waves and my current wave is almost 2 now.  I priced vaccines and was shocked but in my community my patients are not going to the health department for shots if you know what I mean.  I ended up buying what I felt were the bare minimum vaccines and spent around  a thousand dollars.  I bought one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think where everyone else had 10), ppd test solution, adult td, adult hep B.  I think there must be something else but  can't think of it right now.  I figured if I had young kids coming in for well care I could just order what I needed. The rep says he can get the vaccines to me within 48 hours.   Obviously I haven't had any expire yet.  

[Guest guest]

I have a friend who is a pediatrician in a group of 5 others. They actually make a little money on immunizations because they do a huge quantity, buy the "big" bottle" and never have any wasted. She also notes that well care for the under 2's is where they are paid the best for outpatient care. It pays for them to have lots of well babies, and luckily they do.(she does no procedures beyond cerumen removal)

[Guest guest]

I haven't seen anyone mention getting vaccines from McKesson in this thread. Our nurse calls them first, when we need vaccines, and then calls the vaccine manufacturers to compare. Often, McKesson will give us a better price. Also, they will ship us as little as three doses of MMR, etc., and we receive it the next day. In fact, last week we ordered 2 pediatric Hep A doses from McKesson for a girl who will be going to China with her parents this summer. We got the Twinrix (Hep A and for her parents from Glaxo--Kline because their price was a little better. Sure it has been a hassle but this family came in asking if we would get these so their insurance could be billed. Now they are our patients. They seem very grateful for our trouble. Basically, as others have said, overall vaccines seem to be a break-even proposition for us but since Rian isn't delivering babies we have to be open to doing whatever it takes to care for young families. The larger clinic across town would be happy to have PAs give them shots in their "Prompt Care" area, and thus their care would be divided.

Also, our nurse found out that expired vaccines can sometimes be returned for credit. We simply mailed them (unrefrigerated) to some address in Milwaukee and a few weeks later we received credit from Sanofi-Pasteur for several returned doses of adult Hep B which I then applied to a recent invoice. Be sure to ask about return policies.

a Mintek

Rian Mintek MD

Allegan, MI

Vaccine costs

How much can I expect to spend to stock a refrigerator with the minimum number of doses of all adult and pediatric vaccines? I was thinking of avoiding all the pediatric vaccines at start up but I think I will now have to have them within a month or two of opening.

Also, how much vaccine do you all waste due to expiration before you can use it?

Thanks!mkcl6@... wrote:

I am certain my carrier knows about the trigger point and the joint injections. The things that were sure to raise my malpractice by thousands were things like leep, circumcision etc... definitely not trigger point. I'm not sure why your agent would think a trigger point injectio! n is so high risk, I kind of doubt the underwriter would think so. That may be something you would want to ask them if you want to do them.

Yahoo! Autos. Looking for a sweet ride? Get pricing, reviews, & more on new and used cars.

No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.375 / Virus Database: 267.15.7/259 - Release Date: 02/13/2006

[Guest guest]

What are the ‘new vaccine administrative

codes’ please?

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From:

[mailto: ] On

Behalf Of Larry Lindeman

Sent: Tuesday, February 14, 2006

9:33 AM

To:

Subject: Re:

Vaccine costs

In my area I get reimbursed about my cost for vaccines. If you

get reimbursed a lot less, this might be an area that you could negotiate with

payors. We tried that a few years ago by showing our actual invoices for

vaccines to one payor and got an increase. In our area I'm am getting up to $20

for the 1st administrative fee and $12 for each additional vaccine under the

new vaccine administrative codes for children under 8. Make sure that you add

this income when trying to decide whether to give vaccines or not. Also if

preventive care is a covered benefit I usually get a lot more money for these

visits than I do for a sick visit for children. Because of this I find that

seeing babies to be both financially and personally rewarding.

Larry Lindeman

I started out not planning to do

vaccines because of the cost.. Then a family for whom I had delivered one baby

during residency and who had followed me to private practice had another baby

(delivered by OB)

and they BEGGED me to do the baby’s well care. So I said “Let me see if I can”

.. I priced all the vaccines I would need to immunize a child to age 2, and

made the assumption that I would NOT have to throw away unused doses (probably

a bad assumption, but I was really trying to see a way to do this). The cost

was going to run about $1200. Then I called their insurance and got the allowed

amounts on those vaccines. For the 2 years worth of shots that I was going to

have to pay $1200 to buy, they were going to pay me $530. Needless to say, I

had to tell the family that I couldn’t afford to throw away almost $700.

They just had their

fourth baby (4 girls!) and I wish I could be that baby’s doc, but no can do. I

do see the kids for sick visits, but they go topeds for well care.

Annie

-----Original

Message-----

From:

[mailto: ]

On Behalf Of mkcl6@...

Sent:

Tuesday, February 14, 2006 7:10 AM

To:

Subject:

Re: Vaccine costs

I see

both kids and adults, but not so many babies. I feel like they come in

waves and my current wave is almost 2 now. I priced vaccines and was

shocked but in my community my patients are not going to the health department

for shots if you know what I mean. I ended up buying what I felt were the

bare minimum vaccines and spent around a thousand dollars. I bought

one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think

where everyone else had 10), ppd test solution, adult td, adult hep B. I

think there must be something else but can't think of it right now.

I figured if I had young kids coming in for well care I could just order what I

needed. The rep says he can get the vaccines to me within 48 hours.

Obviously I haven't had any expire yet.

[Guest guest]

What are the ‘new vaccine administrative

codes’ please?

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From:

[mailto: ] On

Behalf Of Larry Lindeman

Sent: Tuesday, February 14, 2006

9:33 AM

To:

Subject: Re:

Vaccine costs

In my area I get reimbursed about my cost for vaccines. If you

get reimbursed a lot less, this might be an area that you could negotiate with

payors. We tried that a few years ago by showing our actual invoices for

vaccines to one payor and got an increase. In our area I'm am getting up to $20

for the 1st administrative fee and $12 for each additional vaccine under the

new vaccine administrative codes for children under 8. Make sure that you add

this income when trying to decide whether to give vaccines or not. Also if

preventive care is a covered benefit I usually get a lot more money for these

visits than I do for a sick visit for children. Because of this I find that

seeing babies to be both financially and personally rewarding.

Larry Lindeman

I started out not planning to do

vaccines because of the cost.. Then a family for whom I had delivered one baby

during residency and who had followed me to private practice had another baby

(delivered by OB)

and they BEGGED me to do the baby’s well care. So I said “Let me see if I can”

.. I priced all the vaccines I would need to immunize a child to age 2, and

made the assumption that I would NOT have to throw away unused doses (probably

a bad assumption, but I was really trying to see a way to do this). The cost

was going to run about $1200. Then I called their insurance and got the allowed

amounts on those vaccines. For the 2 years worth of shots that I was going to

have to pay $1200 to buy, they were going to pay me $530. Needless to say, I

had to tell the family that I couldn’t afford to throw away almost $700.

They just had their

fourth baby (4 girls!) and I wish I could be that baby’s doc, but no can do. I

do see the kids for sick visits, but they go topeds for well care.

Annie

-----Original

Message-----

From:

[mailto: ]

On Behalf Of mkcl6@...

Sent:

Tuesday, February 14, 2006 7:10 AM

To:

Subject:

Re: Vaccine costs

I see

both kids and adults, but not so many babies. I feel like they come in

waves and my current wave is almost 2 now. I priced vaccines and was

shocked but in my community my patients are not going to the health department

for shots if you know what I mean. I ended up buying what I felt were the

bare minimum vaccines and spent around a thousand dollars. I bought

one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think

where everyone else had 10), ppd test solution, adult td, adult hep B. I

think there must be something else but can't think of it right now.

I figured if I had young kids coming in for well care I could just order what I

needed. The rep says he can get the vaccines to me within 48 hours.

Obviously I haven't had any expire yet.

[Guest guest]

When I was ordering, I noted you also have to consider if what they charge for shipping, some of them are huge.

[Guest guest]

The codes have actually been out for about 1 year. For children under 8 when the physician explains the risks of the vaccines you use 90465 for the first vaccine and 90466 for each additional vaccine. You use these in addition to the codes for the vaccines themselves. There are different codes for patients over 8 years or when someone other than the doctor explains the risks such as a nurse.Larry LIndemanWhat are the ‘new vaccine administrative codes’ please?  A. Eads, M.D.Pinnacle Family Medicine, PLLC phone faxP.O. Box 7275Woodland Park, CO 80863From: [mailto: ] On Behalf Of Larry LindemanSent: Tuesday, February 14, 2006 9:33 AMTo: Subject: Re: Vaccine costs In my area I get reimbursed  about my cost for vaccines. If you get reimbursed a lot less, this might be an area that you could negotiate with payors. We tried that a few years ago by showing our actual invoices for vaccines to one payor and got an increase. In our area I'm am getting up to $20 for the 1st administrative fee and $12 for each additional vaccine under the new vaccine administrative codes for children under 8. Make sure that you add this income when trying to decide whether to give vaccines or not. Also if preventive care is a covered benefit I usually get a lot more money for these visits than I do for a sick visit for children. Because of this I find that seeing babies to be both financially and personally rewarding.  Larry Lindeman I started out not planning to do vaccines because of the cost..  Then a family for whom I had delivered one baby during residency and who had followed me to private practice had another baby (delivered by OB) and they BEGGED me to do the baby’s well care.  So I said “Let me see if I can” .  I priced all the vaccines I would need to immunize a child to age 2, and made the assumption that I would NOT have to throw away unused doses (probably a bad assumption, but I was really trying to see a way to do this).  The cost was going to run about $1200. Then I called their insurance and got the allowed amounts on those vaccines.  For the 2 years worth of shots that I was going to have to pay $1200 to buy, they were going to pay me $530.  Needless to say, I had to tell the family that I couldn’t afford to throw away almost $700. They just had their fourth baby (4 girls!) and I wish I could be that baby’s doc, but no can do.  I do see the kids for sick visits, but they go topeds for well care.Annie -----Original Message-----From: [mailto: ] On Behalf Of mkcl6@...Sent: Tuesday, February 14, 2006 7:10 AMTo: Subject: Re: Vaccine costs I see both kids and adults, but not so many babies.  I feel like they come in waves and my current wave is almost 2 now.  I priced vaccines and was shocked but in my community my patients are not going to the health department for shots if you know what I mean.  I ended up buying what I felt were the bare minimum vaccines and spent around  a thousand dollars.  I bought one dose of varivax, the smallest MMR (someone offered a 5 dose Caligor I think where everyone else had 10), ppd test solution, adult td, adult hep B.  I think there must be something else but  can't think of it right now.  I figured if I had young kids coming in for well care I could just order what I needed. The rep says he can get the vaccines to me within 48 hours.   Obviously I haven't had any expire yet.