Re: Flu vaccine billing

[Guest guest]

If you participate with their insurance, then you will need to bill their insurance. You can only do flat fees for uninsured or for a patient who’s plan you are not in. Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: [mailto: ] On Behalf Of thorsonejt@...Sent: Sunday, October 09, 2011 11:48 AMTo: Subject: Flu vaccine billing First time poster here, but have spent the last 12 months as a tourist on the practiceimprovement group and have learned plenty of great tips. I finished residency in June 2010, went to IMP camp last year, and now have run my IMP style practice since Jan 2011. I am looking for advice on how others handle the seasonal flu shot billing. Specifically, my assumption is that it would be a covered benefit with most insurers and therefore as a contracted provider I would be required to file the claim with my standard administration fee plus fee for vaccine. I am thinking it would be a violation of my contracts to charge the patient cash ($25 flat fee) and not deal with filing the claim for them, or asking them file with their insurance. Is this correct? Obviously my preference would be to simply charge a flat fee, give it to anyone coming through the door, and not deal with insurance. Thanks for any input. Town Clinic of Crested Butte

[Guest guest]

I agree with what was already said - if you are a participating provider, you will need to bill insurance.Everyone who is a Medicare provider should also pay attention to the new codes that went into effect 1/1/11.  There is now a Q code for each specific flu vaccine. 

Pratt

 

First time poster here, but have spent the last 12 months as a tourist on the practiceimprovement group and have learned plenty of great tips. I finished residency in June 2010, went to IMP camp last year, and now have run my IMP style practice since Jan 2011. I am looking for advice on how others handle the seasonal flu shot billing. Specifically, my assumption is that it would be a covered benefit with most insurers and therefore as a contracted provider I would be required to file the claim with my standard administration fee plus fee for vaccine. I am thinking it would be a violation of my contracts to charge the patient cash ($25 flat fee) and not deal with filing the claim for them, or asking them file with their insurance. Is this correct? Obviously my preference would be to simply charge a flat fee, give it to anyone coming through the door, and not deal with insurance.

Thanks for any input.

Town Clinic of Crested Butte

[Guest guest]

That is what I assumed, thanks for the confirmationSent from my Verizon Wireless Phone----- Reply message -----Date: Sun, Oct 9, 2011 9:26 pmSubject: Flu vaccine billingTo: " " < >I agree with what was already said - if you are a participating provider,you will need to bill insurance.Everyone who is a Medicare provider should also pay attention to the newcodes that went into effect 1/1/11. There is now a Q code for each specificflu vaccine. PrattOn Oct 9, 2011, at 8:48 AM, " thorsonejt@... " wrote:First time poster here, but have spent the last 12 months as a tourist onthe practiceimprovement group and have learned plenty of great tips. Ifinished residency in June 2010, went to IMP camp last year, and now haverun my IMP style practice since Jan 2011. I am looking for advice on howothers handle the seasonal flu shot billing. Specifically, my assumption isthat it would be a covered benefit with most insurers and therefore as acontracted provider I would be required to file the claim with my standardadministration fee plus fee for vaccine. I am thinking it would be aviolation of my contracts to charge the patient cash ($25 flat fee) and notdeal with filing the claim for them, or asking them file with theirinsurance. Is this correct? Obviously my preference would be to simplycharge a flat fee, give it to anyone coming through the door, and not dealwith insurance.Thanks for any input.Town Clinic of Crested Butte

[Guest guest]

You need to bill their insurance adn in Colo it is paid in full. I believe that we get about 59 dollars from most of the insurers for vaccine and administrative costs. Be sure you are using the correct codes, they are different for Medicare and flumist

than for adults.

I was in CB a few weeks ago, did not know you were there. I am in Winter Park, come by if you get up this way.

From: [ ] On Behalf Of thorsonejt@... [thorsonejt@...]

Sent: Sunday, October 09, 2011 9:48 AM

To:

Subject: Flu vaccine billing

First time poster here, but have spent the last 12 months as a tourist on the practiceimprovement group and have learned plenty of great tips. I finished residency in June 2010, went to IMP camp last year, and now have run my IMP style practice since Jan

2011. I am looking for advice on how others handle the seasonal flu shot billing. Specifically, my assumption is that it would be a covered benefit with most insurers and therefore as a contracted provider I would be required to file the claim with my standard

administration fee plus fee for vaccine. I am thinking it would be a violation of my contracts to charge the patient cash ($25 flat fee) and not deal with filing the claim for them, or asking them file with their insurance. Is this correct? Obviously my preference

would be to simply charge a flat fee, give it to anyone coming through the door, and not deal with insurance.

Thanks for any input.

Town Clinic of Crested Butte

[Guest guest]

Hi !

Eads

here, from Colorado Springs. I remember meeting you at Camp last year, and

wondered how you were doing. Glad to learn your practice is up and running!

Hope all is

well and feel free to visit if you come down from the mountains. I’ll have to

look you up if I get to ski in your area this winter

Eads, MD

Pinnacle Family Medicine

Colorado Springs, CO

www.PinnacleFamilyMedicine.com

From:

[mailto: ] On Behalf Of thorsonejt@...

Sent: Sunday, October 09, 2011 9:48 AM

To:

Subject: Flu vaccine billing

First time poster here, but have spent the last

12 months as a tourist on the practiceimprovement group and have learned plenty

of great tips. I finished residency in June 2010, went to IMP camp last year,

and now have run my IMP style practice since Jan 2011. I am looking for advice

on how others handle the seasonal flu shot billing. Specifically, my assumption

is that it would be a covered benefit with most insurers and therefore as a

contracted provider I would be required to file the claim with my standard

administration fee plus fee for vaccine. I am thinking it would be a violation

of my contracts to charge the patient cash ($25 flat fee) and not deal with

filing the claim for them, or asking them file with their insurance. Is this

correct? Obviously my preference would be to simply charge a flat fee, give it

to anyone coming through the door, and not deal with insurance.

Thanks for any input.

Town Clinic of Crested Butte