Re: flu vaccine consent and patient consents

November 15, 2006

You do

a consent form just for a flu shot? We sure don’t.

flu vaccine consent and patient consents

Hello,

I am trying to get ready to give my first flu vaccines tomorrow

(if they arrive today as schedule), and I'm trying to figure out how

to do the consents. I found the VIS (vaccine info statements) put out

my the CDC, but they don't have a consent form on it. I tried

searching our old posting, but I can't find it. Could someone give me

the link or info?

Does anyone have an initial patient consent combo (HIPPA, E-mail,

consent to treat, etc.) that they are happy with & wouldn't mind

sharing?

Thanks,

Sharon

(remodeler, painter, secretary, marketing director, janitor, soon-to-

be more, doctor)

November 15, 2006

I have an overdone form I used in the past. It needs to be updated a little -- but isn't too bad. http://www.alpinemedical.md/intranet/Forms/Administrative/FluShotEncounterConsentForm.docTechnically, you don't need to get a signature for the flu shot...at least for adults.

http://www.cdc.gov/Nip/publications/vis/vis-facts.htm

Providers May

Add a practice’s name, address, or phone number to an existing VIS. If the publication date is cut off during downloading, add the date.

Give out VISs at other times, in addition to prior to vaccine administration, (e.g., pre-natal visits).

Have a recipient or their parent or legal representative sign a separate “informed consent” form if it is required by your state. There is no Federal requirement for written informed consent for vaccinations, and VISs are not informed consent forms, but some states have such requirements.

================================

Arch Intern Med. 2004 Jan 12;164(1):13-6.

Is signed consent for influenza or pneumococcal polysaccharide vaccination required?

Kissam S,

Gifford DR,

Patry G,

Bratzler DW.

Quality Partners of Rhode Island, and the Oklahoma Foundation for Medical Quality, Oklahoma City, Oklahoma, USA.

Each year, thousands of preventable deaths and hospitalizations result from complications of influenza and pneumococcal disease, mostly in elderly persons, despite the availability of vaccines. Obtaining signed consent prior to administering the vaccines represents an obstacle to achieving the Healthy People 2010 goals for vaccinating individuals against influenza and pneumococcal disease. Signed consent is neither legally mandated nor a guarantee that the patient (or proxy) has given informed consent. Nonetheless, many health care providers and institutions currently require signed consent before administering these vaccines. Rather, health care providers should use the Vaccine Information Sheets developed by the Centers for Disease Control and Prevention to inform patients about the risks and benefits associated with these vaccines. Requiring signed consent before administering these low-risk, high-benefit vaccines is inconsistent with the current practice of not requiring signed consent before prescribing other common treatments, eg, antibiotic treatment, whose risk levels are the same or higher.

Locke, MD-----Original Message-----From: [mailto: ] On Behalf Of sharigeorgeSent: Wednesday, November 15, 2006 12:31 PMTo: Subject: flu vaccine consent and patient consentsHello, I am trying to get ready to give my first flu vaccines tomorrow (if they arrive today as schedule), and I'm trying to figure out how to do the consents. I found the VIS (vaccine info statements) put out my the CDC, but they don't have a consent form on it. I tried searching our old posting, but I can't find it. Could someone give me the link or info? Does anyone have an initial patient consent combo (HIPPA, E-mail, consent to treat, etc.) that they are happy with & wouldn't mind sharing?Thanks,Sharon (remodeler, painter, secretary, marketing director, janitor, soon-to- be more, doctor)

November 15, 2006

Maybe I don't need to & that's why I can't find it. Thanks.At

12:03 PM 11/15/2006, you wrote:

You

do a consent form just for a flu shot? We sure don’t.

flu vaccine consent and patient

consents

Hello,

I am trying to get ready to give my first flu vaccines tomorrow

(if they arrive today as schedule), and I'm trying to figure out how

to do the consents. I found the VIS (vaccine info statements) put out

my the CDC, but they don't have a consent form on it. I tried

searching our old posting, but I can't find it. Could someone give me

the link or info?

Does anyone have an initial patient consent combo (HIPPA, E-mail,

consent to treat, etc.) that they are happy with & wouldn't mind

sharing?

Thanks,

Sharon

(remodeler, painter, secretary, marketing director, janitor,

soon-to-

be more, doctor)

No virus found in this incoming message.

Checked by AVG Free Edition.

Version: 7.0.409 / Virus Database: 268.14.5/534 - Release Date:

11/14/2006

Sharon McCoy , M.D.

Renaissance Family Medicine

The

Rebirth of Personal Healthcare

www.SharonMD.com

Phone Fax (949)

281-2197

No virus found in this outgoing message.

Checked by AVG Free Edition.

Version: 7.0.409 / Virus Database: 268.14.5/534 - Release Date: 11/14/2006

November 15, 2006

A month or two ago I decided to go with the " sign one page " plan for the

privacy/consent to treat form (see below.... I've copied/pasted since I

don't think the listserv allows attachments) and I keep copies of the

privacy practice policies in the magazine rack in my front room. Some of

the wording/ideas were " stolen " from the recent discussions we had on the

list.

Also below should be the page I have patients sign for adult vaccinations.

I simply give them the printout from the CDC, offer counselling and have

them sign the sheet.

Note -- I've not had any lawyers or consultants preview/review these.

But I hope they help.

Good luck with the flu shot...

Tim

First, the vax sheet...

Patient: ______________________________________ DOB:_________________

My signature with each vaccination below signifies:

• Information related to the vaccination has been given to me,

• my questions have been addressed to my satisfaction

• I understand the reason for the vaccine and the potential for risks as

described in the information given, and

• I agree to the administration of the vaccination by Dr. Malia or staff.

Vaccine Date Name Signature

Tetanus (Td)

Pneumovax

Meningitis

Flu shot

.... now the consent for care sheet....

• I authorize Malia, MD to provide me medical services.

• I authorize my insurance benefits, if any, to be paid directly to

Malia, MD or Malia Family Medicine.

• I agree to pay any co-payments as required by my insurance at time of

service.

• I understand I am financially responsible for any balance not paid by

insurance.

• I acknowledge satisfactory receipt of the Notice of Privacy Practices

for Malia Family Medicine and understand I may obtain a paper copy of

this Notice of Privacy Practices upon request.

• I authorize the release of any of my medical information necessary for

care or treatment, or to process an insurance claim.

• If such information, released with proper intent, is later misused by

other parties, I release Dr. Malia from liability.

• I authorize the use of scanned/copied images in place of originals for

all documents and signatures in my medical record.

• I understand I am responsible to notify Malia Family Medicine at least

24 hours prior to an appointment I can not keep, and that Dr. Malia

maintains the right to charge me for appointments not attended or

cancelled in a timely manner.

• I authorize Dr. Malia to contact me by letter, phone, fax, on-line or to

leave recorded messages if appropriate for medical care or planning of

such care.

• I understand that I am responsible for a per-page nominal charge to copy

and send medical records when requested.

• I authorize Dr. Malia to communicate issues of my health conditions and

medical care with the following people (please list name and

phone/fax/email):

_________________________________________________________________________

________________________________________________________________________________\

__________________________________________________________________

_________________________________________________________________________

Patient Name ____________________________________________

DOB ___________________________________________________

Phone___________________________________________________

Address_________________________________________________________________

________________________________________________________________________

Signature _______________________________________ Date ___________________

Name & relationship to patient if

other:________________________________________

________________________________________________________________________

--

Malia, MD

Malia Family Medicine & Skin Sense Laser

6720 Pittsford-Palmyra Rd.

Perinton Square Mall

Fairport, NY 14450

(phone / fax)

www.relayhealth.com/doc/DrMalia

www.SkinSenseLaser.com

-- Confidentiality Notice --

This email message, including all the attachments, is for the sole use of

the intended recipient(s) and contains confidential information.

Unauthorized use or disclosure is prohibited. If you are not the intended

recipient, you may not use, disclose, copy or disseminate this

information. If you are not the intended recipient, please contact the

sender immediately by reply email and destroy all copies of the original

message, including attachments.

> Hello,

> I am trying to get ready to give my first flu vaccines tomorrow

> (if they arrive today as schedule), and I'm trying to figure out how to

> do the consents. I found the VIS (vaccine info statements) put out my

> the CDC, but they don't have a consent form on it. I tried

> searching our old posting, but I can't find it. Could someone give me

> the link or info?

> Does anyone have an initial patient consent combo (HIPPA, E-mail,

> consent to treat, etc.) that they are happy with & wouldn't mind

> sharing?

>

> Thanks,

> Sharon

> (remodeler, painter, secretary, marketing director, janitor, soon-to- be

> more, doctor)

>

November 15, 2006

Sharon,I don't make patients sign consent forms for vaccinations (does anyone?). I just chart that I explained the risks/benefits and they agree to get the shot. For children, I chart that I gave the parent the VIS and counseled them about the immunization. Here are my copies of consents for HIPAA and E-mail that you are welcome to use. I am also sending this to you directly because sometimes people have problems opening attachments on this listserve.Good luck tomorrow! SetoSouth Pasadena, CAHello,I am trying to get ready to give my first flu vaccines tomorrow (if they arrive today as schedule), and I'm trying to figure out how to do the consents. I found the VIS (vaccine info statements) put out my the CDC, but they don't have a consent form on it. I tried searching our old posting, but I can't find it. Could someone give me the link or info?Does anyone have an initial patient consent combo (HIPPA, E-mail, consent to treat, etc.) that they are happy with & wouldn't mind sharing?Thanks,Sharon (remodeler, painter, secretary, marketing director, janitor, soon-to-be more, doctor)

November 15, 2006

The AAFP (I think) had a form that I put in my Policies and Procedures stating how/why I give flu shots. I haven't otherwise bothered for consents. NOn Nov 15, 2006, at 1:22 PM, Sharon McCoy , M.D. wrote: Maybe I don't need to & that's why I can't find it. Thanks.At 12:03 PM 11/15/2006, you wrote: You do a consent form just for a flu shot? We sure don’t. flu vaccine consent and patient consents Hello, I am trying to get ready to give my first flu vaccines tomorrow (if they arrive today as schedule), and I'm trying to figure out how to do the consents. I found the VIS (vaccine info statements) put out my the CDC, but they don't have a consent form on it. I tried searching our old posting, but I can't find it. Could someone give me the link or info? Does anyone have an initial patient consent combo (HIPPA, E-mail, consent to treat, etc.) that they are happy with & wouldn't mind sharing? Thanks, Sharon (remodeler, painter, secretary, marketing director, janitor, soon-to- be more, doctor) No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.0.409 / Virus Database: 268.14.5/534 - Release Date: 11/14/2006 Sharon McCoy , M.D. Renaissance Family Medicine The Rebirth of Personal Healthcare www.SharonMD.com Phone Fax No virus found in this outgoing message.Checked by AVG Free Edition.Version: 7.0.409 / Virus Database: 268.14.5/534 - Release Date: 11/14/2006

November 15, 2006

You guys are great! Thanks for the quick, helpful replies.

Like I told , just when I was starting to feel all alone

here....

Sharon

At 12:16 PM 11/15/2006, you wrote:

I have an

overdone form I used in the past. It needs to be updated a little -- but

isn't too bad.

http://www.alpinemedical.md/intranet/Forms/Administrative/FluShotEncounterConsentForm.doc

Technically, you don't need to get a signature for the flu shot...at

least for adults.

http://www.cdc.gov/Nip/publications/vis/vis-facts.htm

Providers May

Add a practice’s name, address, or phone number to an existing VIS.

If the publication date is cut off during downloading, add the date.

Give out VISs at other times, in addition to prior to vaccine

administration, (e.g., pre-natal visits).

Have a recipient or their parent or legal representative sign a

separate “informed consent” form if it is required by your state. There

is no Federal requirement for written informed consent for vaccinations,

and VISs are not informed consent forms, but some states have such

requirements. ================================

Arch Intern Med. 2004 Jan 12;164(1):13-6.

Is signed consent for influenza or pneumococcal polysaccharide

vaccination required?

Kissam S,

Gifford DR,

Patry G,

Bratzler DW.

Quality Partners of Rhode Island, and the Oklahoma Foundation for Medical

Quality, Oklahoma City, Oklahoma, USA.

Each year, thousands of preventable deaths and hospitalizations result

from complications of influenza and pneumococcal disease, mostly in

elderly persons, despite the availability of vaccines. Obtaining signed

consent prior to administering the vaccines represents an obstacle to

achieving the Healthy People 2010 goals for vaccinating individuals

against influenza and pneumococcal disease. Signed consent is neither

legally mandated nor a guarantee that the patient (or proxy) has given

informed consent. Nonetheless, many health care providers and

institutions currently require signed consent before administering these

vaccines. Rather, health care providers should use the Vaccine

Information Sheets developed by the Centers for Disease Control and

Prevention to inform patients about the risks and benefits associated

with these vaccines. Requiring signed consent before administering these

low-risk, high-benefit vaccines is inconsistent with the current practice

of not requiring signed consent before prescribing other common

treatments, eg, antibiotic treatment, whose risk levels are the same or

higher.

Locke, MD

flu vaccine consent and patient

consents

Hello,

I am trying to get ready to give my first flu vaccines

tomorrow (if they arrive today as schedule), and I'm trying to figure out

how to do the consents. I found the VIS (vaccine info statements)

put out my the CDC, but they don't have a consent form on it. I

tried searching our old posting, but I can't find it. Could someone

give me the link or info?

Does anyone have an initial patient consent combo

(HIPPA, E-mail, consent to treat, etc.) that they are happy with &

wouldn't mind sharing?

Thanks,

Sharon

(remodeler, painter, secretary, marketing director, janitor, soon-to- be

more, doctor)

November 16, 2006

We got an “extra” shipment of

shots that got pulled off a waiting list and sent non-returnable. So we have

set up a flu clinic at our church for this weekend. I put this form together

for consent and to gather billing info on patients that won’t be in our

practice.

From: [mailto: ] On Behalf Of sharigeorge

Sent: Wednesday, November 15, 2006

12:31 PM

To:

Subject:

flu vaccine consent and patient consents

Hello,

I am trying to get ready to give my first flu vaccines tomorrow

(if they arrive today as schedule), and I'm trying to figure out how

to do the consents. I found the VIS (vaccine

info statements) put out

my the CDC, but they don't have a consent form on it. I tried

searching our old posting, but I can't find it. Could someone give me

the link or info?

Does anyone have an initial patient consent combo (HIPPA, E-mail,

consent to treat, etc.) that they are happy with & wouldn't mind

sharing?

Thanks,

Sharon

(remodeler, painter, secretary, marketing director, janitor, soon-to-

be more, doctor)

November 16, 2006

I read with interest how people handle flu shot consents. But how do people handle billing for flu-shot only visits? Do you bill insurance? If so for a nurse-only 99211 plus vaccine plus administration? Do most people just charge a flat fee for flu vaccines without billing insurance? Thanks"Sharon McCoy , M.D." wrote: You guys are great! Thanks for the quick, helpful replies. Like I told , just when I was starting to feel all alone

here....SharonAt 12:16 PM 11/15/2006, you wrote: I have an overdone form I used in the past. It needs to be updated a little -- but isn't too bad. http://www.alpinemedical.md/intranet/Forms/Administrative/FluShotEncounterConsentForm.doc Technically, you don't need to get a signature for the flu shot...at least for adults. http://www.cdc.gov/Nip/publications/vis/vis-facts.htm Providers May Add a practice’s name, address, or phone number to an existing VIS. If the publication date is cut off during

downloading, add the date. Give out VISs at other times, in addition to prior to vaccine administration, (e.g., pre-natal visits). Have a recipient or their parent or legal representative sign a separate “informed consent” form if it is required by your state. There is no Federal requirement for written informed consent for vaccinations, and VISs are not informed consent forms, but some states have such requirements. ================================ Arch Intern Med. 2004 Jan 12;164(1):13-6. Is signed consent for influenza or pneumococcal polysaccharide vaccination required? Kissam S, Gifford DR, Patry G, Bratzler DW. Quality Partners of Rhode Island, and the Oklahoma Foundation for Medical Quality, Oklahoma City, Oklahoma, USA.Each year, thousands of preventable deaths and hospitalizations result from complications of influenza and pneumococcal disease, mostly in elderly persons, despite the availability of vaccines. Obtaining signed consent prior to administering the vaccines represents an obstacle to achieving the Healthy People 2010 goals for

vaccinating individuals against influenza and pneumococcal disease. Signed consent is neither legally mandated nor a guarantee that the patient (or proxy) has given informed consent. Nonetheless, many health care providers and institutions currently require signed consent before administering these vaccines. Rather, health care providers should use the Vaccine Information Sheets developed by the Centers for Disease Control and Prevention to inform patients about the risks and benefits associated with these vaccines. Requiring signed consent before administering these low-risk, high-benefit vaccines is inconsistent with the current practice of not requiring signed consent before prescribing other common treatments, eg, antibiotic treatment, whose risk levels are the same or higher. Locke, MD-----Original Message-----From: [

mailto: ] On Behalf Of sharigeorgeSent: Wednesday, November 15, 2006 12:31 PMTo: Subject: flu vaccine consent and patient consentsHello, I am trying to get ready to give my first flu vaccines tomorrow (if they arrive today as schedule), and I'm trying to figure out how to do the consents. I found the VIS (vaccine info statements) put out my the CDC, but they don't have a consent form on it. I tried searching our old posting, but I can't find it. Could someone give me the link or info? Does anyone have an initial patient consent combo (HIPPA, E-mail, consent to treat, etc.) that they are happy with & wouldn't mind sharing?Thanks,Sharon (remodeler, painter, secretary, marketing director, janitor, soon-to- be more,

doctor)

November 16, 2006

I read with interest how people handle flu shot consents. But how do people handle billing for flu-shot only visits? Do you bill insurance? If so for a nurse-only 99211 plus vaccine plus administration? Do most people just charge a flat fee for flu vaccines without billing insurance? Thanks"Sharon McCoy , M.D." wrote: You guys are great! Thanks for the quick, helpful replies. Like I told , just when I was starting to feel all alone

here....SharonAt 12:16 PM 11/15/2006, you wrote: I have an overdone form I used in the past. It needs to be updated a little -- but isn't too bad. http://www.alpinemedical.md/intranet/Forms/Administrative/FluShotEncounterConsentForm.doc Technically, you don't need to get a signature for the flu shot...at least for adults. http://www.cdc.gov/Nip/publications/vis/vis-facts.htm Providers May Add a practice’s name, address, or phone number to an existing VIS. If the publication date is cut off during

downloading, add the date. Give out VISs at other times, in addition to prior to vaccine administration, (e.g., pre-natal visits). Have a recipient or their parent or legal representative sign a separate “informed consent” form if it is required by your state. There is no Federal requirement for written informed consent for vaccinations, and VISs are not informed consent forms, but some states have such requirements. ================================ Arch Intern Med. 2004 Jan 12;164(1):13-6. Is signed consent for influenza or pneumococcal polysaccharide vaccination required? Kissam S, Gifford DR, Patry G, Bratzler DW. Quality Partners of Rhode Island, and the Oklahoma Foundation for Medical Quality, Oklahoma City, Oklahoma, USA.Each year, thousands of preventable deaths and hospitalizations result from complications of influenza and pneumococcal disease, mostly in elderly persons, despite the availability of vaccines. Obtaining signed consent prior to administering the vaccines represents an obstacle to achieving the Healthy People 2010 goals for

vaccinating individuals against influenza and pneumococcal disease. Signed consent is neither legally mandated nor a guarantee that the patient (or proxy) has given informed consent. Nonetheless, many health care providers and institutions currently require signed consent before administering these vaccines. Rather, health care providers should use the Vaccine Information Sheets developed by the Centers for Disease Control and Prevention to inform patients about the risks and benefits associated with these vaccines. Requiring signed consent before administering these low-risk, high-benefit vaccines is inconsistent with the current practice of not requiring signed consent before prescribing other common treatments, eg, antibiotic treatment, whose risk levels are the same or higher. Locke, MD-----Original Message-----From: [

mailto: ] On Behalf Of sharigeorgeSent: Wednesday, November 15, 2006 12:31 PMTo: Subject: flu vaccine consent and patient consentsHello, I am trying to get ready to give my first flu vaccines tomorrow (if they arrive today as schedule), and I'm trying to figure out how to do the consents. I found the VIS (vaccine info statements) put out my the CDC, but they don't have a consent form on it. I tried searching our old posting, but I can't find it. Could someone give me the link or info? Does anyone have an initial patient consent combo (HIPPA, E-mail, consent to treat, etc.) that they are happy with & wouldn't mind sharing?Thanks,Sharon (remodeler, painter, secretary, marketing director, janitor, soon-to- be more,

doctor)

November 16, 2006

We

mostly just submit the CPT code for the flu shot + the admin code. We do not

use the 99211 because the big catch then is that the patient has to pay a co-pay.

We thought about cash only initially, but we had too many of them that came in

for something else and “oh by the way, can I get my flu shot?” It

was easier just to add it to that day’s charges.

flu vaccine consent and patient consents

Hello,

I am trying to get ready to give my first flu vaccines

tomorrow (if they arrive today as schedule), and I'm trying to figure out how

to do the consents. I found the VIS (vaccine info statements) put out my

the CDC, but they don't have a consent form on it. I tried searching our

old posting, but I can't find it. Could someone give me the link or info?

Does anyone have an initial patient consent combo (HIPPA,

E-mail, consent to treat, etc.) that they are happy with & wouldn't mind

sharing?

Thanks,

Sharon

(remodeler, painter, secretary, marketing director, janitor, soon-to- be more,

doctor)

November 16, 2006

We have

been billing the following way:

No insurance or not our patient: $30

Regular insurance: Copay

(and then bill insurance for the rest)

Medicare: No payment from the patient—only

bill Medicare

Caveats to complicate the picture: If a patient

has insurance and the copay is more than what the

insurance reimburses, you may need to bill the insurance in order to find out

how much the patient owes (and therefore not collect a copay at the time of service or “owe”

the patient the difference).

The code for the flu vaccine is 90658

(> age 3) and the administration code is either G0008 (Medicare) or 90471

(most other insurances). Medicare generally pays around $30 for both (which is

where I got my flu shot fee). Other insurances that don’t recognize the

G0008 code pay $10 or so less total for the administration. 99211 cannot be

billed unless some other service is provided.

In general, the flu shot is one of the few

immunizations I can make some money on. My cost was about $12/shot. Medicare

reimburses around $30, I make $18. I will give around 300 shots this year, so

that gives me around a $4,000-$5,000 boost (adjusting for the lower reimbursing

insurances) just for giving an

immunization. Good luck.

flu vaccine consent and patient consents

Hello,

I am trying to get ready to give my first flu vaccines

tomorrow (if they arrive today as schedule), and I'm trying to figure out how

to do the consents. I found the VIS (vaccine info statements) put out my

the CDC, but they don't have a consent form on it. I tried searching our

old posting, but I can't find it. Could someone give me the link or info?

Does anyone have an initial patient consent combo (HIPPA,

E-mail, consent to treat, etc.) that they are happy with & wouldn't mind

sharing?

Thanks,

Sharon

(remodeler, painter, secretary, marketing director, janitor, soon-to- be more,

doctor)

November 16, 2006

We have

been billing the following way:

No insurance or not our patient: $30

Regular insurance: Copay

(and then bill insurance for the rest)

Medicare: No payment from the patient—only

bill Medicare

Caveats to complicate the picture: If a patient

has insurance and the copay is more than what the

insurance reimburses, you may need to bill the insurance in order to find out

how much the patient owes (and therefore not collect a copay at the time of service or “owe”

the patient the difference).

The code for the flu vaccine is 90658

(> age 3) and the administration code is either G0008 (Medicare) or 90471

(most other insurances). Medicare generally pays around $30 for both (which is

where I got my flu shot fee). Other insurances that don’t recognize the

G0008 code pay $10 or so less total for the administration. 99211 cannot be

billed unless some other service is provided.

In general, the flu shot is one of the few

immunizations I can make some money on. My cost was about $12/shot. Medicare

reimburses around $30, I make $18. I will give around 300 shots this year, so

that gives me around a $4,000-$5,000 boost (adjusting for the lower reimbursing

insurances) just for giving an

immunization. Good luck.

flu vaccine consent and patient consents

Hello,

I am trying to get ready to give my first flu vaccines

tomorrow (if they arrive today as schedule), and I'm trying to figure out how

to do the consents. I found the VIS (vaccine info statements) put out my

the CDC, but they don't have a consent form on it. I tried searching our

old posting, but I can't find it. Could someone give me the link or info?

Does anyone have an initial patient consent combo (HIPPA,

E-mail, consent to treat, etc.) that they are happy with & wouldn't mind

sharing?

Thanks,

Sharon

(remodeler, painter, secretary, marketing director, janitor, soon-to- be more,

doctor)

November 16, 2006

Hello all:

This may seem like a basic question, but

from someone who has done very little with Medicare patients…What is the

code for a flu vaccine for Medicare and how about for venipuncture? Our

medicare intermediary has a website where you put in the code and they give you

the allowable rates. BUT, “no match found” is what I get when

I put in the codes that my software (eMD’s) has for these two items.

Thanks.

Ramona

From: [mailto: ] On Behalf Of Brock DO

Sent: Thursday, November 16, 2006

1:53 PM

To:

Subject: RE:

flu vaccine consent and patient consents

We mostly just submit the CPT code for the flu shot + the admin

code. We do not use the 99211 because the big catch then is that the

patient has to pay a co-pay. We thought about cash only initially, but we

had too many of them that came in for something else and “oh by the way,

can I get my flu shot?” It was easier just to add it to that

day’s charges.

-----Original

Message-----

From:

[mailto: ]

On Behalf Of postrio

Sent: Thursday, November 16, 2006

1:25 PM

To:

Subject: RE:

flu vaccine consent and patient consents

I read

with interest how people handle flu shot consents. But how do people

handle billing for flu-shot only visits? Do you bill insurance? If

so for a nurse-only 99211 plus vaccine plus administration? Do most

people just charge a flat fee for flu vaccines without billing insurance?

Thanks

" Sharon McCoy

, M.D. " <sharongeorgemd> wrote:

You guys are

great! Thanks for the quick, helpful replies. Like I told , just when I was

starting to feel all alone here....

Sharon

At 12:16 PM 11/15/2006, you wrote:

I have an

overdone form I used in the past. It needs to be updated a little -- but isn't

too bad.

http://www.alpinemedical.md/intranet/Forms/Administrative/FluShotEncounterConsentForm.doc

Technically, you don't need to get a signature for the flu shot...at least for

adults.

http://www.cdc.gov/Nip/publications/vis/vis-facts.htm

Providers May

·

Add a practice’s name, address, or phone number to

an existing VIS. If the publication date is

cut off during downloading, add the date.

·

Give out VISs at other times, in addition to prior to

vaccine administration, (e.g., pre-natal visits).

·

Have a recipient or their parent or legal representative

sign a separate “informed consent” form if it is required by your

state. There is no Federal requirement for written informed consent for

vaccinations, and VISs are not informed consent forms, but some states have

such requirements.

·

================================

Arch Intern Med. 2004 Jan

12;164(1):13-6.

Is

signed consent for influenza or pneumococcal polysaccharide vaccination

required?

·

Kissam

S,

·

Gifford

DR,

·

Patry

G,

·

Bratzler

DW.

Quality Partners of Rhode Island, and the Oklahoma Foundation for Medical Quality, Oklahoma City, Oklahoma,

USA.

Each year, thousands of preventable deaths and hospitalizations result from

complications of influenza and pneumococcal disease, mostly in elderly persons,

despite the availability of vaccines. Obtaining signed consent prior to

administering the vaccines represents an obstacle to achieving the Healthy

People 2010 goals for vaccinating individuals against influenza and

pneumococcal disease. Signed consent is neither legally mandated nor a

guarantee that the patient (or proxy) has given informed consent. Nonetheless,

many health care providers and institutions currently require signed consent

before administering these vaccines. Rather, health care providers should use

the Vaccine Information Sheets developed by the Centers for Disease Control and

Prevention to inform patients about the risks and benefits associated with

these vaccines. Requiring signed consent before administering these low-risk,

high-benefit vaccines is inconsistent with the current practice of not

requiring signed consent before prescribing other common treatments, eg, antibiotic

treatment, whose risk levels are the same or higher.

Locke, MD

flu vaccine consent and patient consents

Hello,

I am trying to get ready to give my first flu vaccines tomorrow

(if they arrive today as schedule), and I'm trying to figure out how to do the

consents. I found the VIS (vaccine info

statements) put out my the CDC, but they don't have a consent form on it.

I tried searching our old posting, but I can't find it. Could someone

give me the link or info?

Does anyone have an initial patient consent combo (HIPPA,

E-mail, consent to treat, etc.) that they are happy with & wouldn't mind

sharing?

Thanks,

Sharon

(remodeler, painter, secretary, marketing director, janitor, soon-to- be more,

doctor)

November 16, 2006

Thank you!

I am non-par with most insurances and $30

is my flu vaccine charge, (glad to hear I am not too “off the mark”).

I will try these codes in the trailblazers website!

Ramona

From: [mailto: ] On Behalf Of Brady, MD

Sent: Thursday, November 16, 2006

2:09 PM

To:

Subject: RE:

flu vaccine consent and patient consents

We have been billing the following way:

No insurance or not our patient: $30

Regular insurance: Copay (and then bill

insurance for the rest)

Medicare: No payment from the patient—only bill Medicare

Caveats to complicate the picture: If a patient has insurance and

the copay is more than what the insurance reimburses,

you may need to bill the insurance in order to find out how much the patient

owes (and therefore not collect a copay

at the time of service or “owe” the patient the difference).

The code for the flu vaccine is 90658 (> age 3) and the

administration code is either G0008 (Medicare) or 90471 (most other

insurances). Medicare generally pays around $30 for both (which is where I got

my flu shot fee). Other insurances that don’t recognize the G0008 code

pay $10 or so less total for the administration. 99211 cannot be billed unless

some other service is provided.

In general, the flu shot is one of the few immunizations I can make

some money on. My cost was about $12/shot. Medicare reimburses around $30, I

make $18. I will give around 300 shots this year, so that gives me around a

$4,000-$5,000 boost (adjusting for the lower reimbursing insurances) just

for giving an immunization. Good luck.