Hello I work at a Rural Health Clinic. We have several scenarios for flu shots. We cannot bill traditional Medicare for beneficiaries who receive the flu vaccine as we are reimbursed through our cost report for influenza and pneumonia vaccines.
We do need to bill Medicare Advantage plans for these immunizations as they are not reimbursable on the cost report.
We have VFC which requires us to bill a penny for the vaccine and bill the administration fee but we are not paid for these.
We then have our “commercial” insurance that we will bill for vaccines. We have fluzone and an under 3 vaccine. How do you handle all of these different billing scenarios with one lot # (two lot #s for all the influenza we have in house).
We have templates setup for the flu vaccines that will automatically populate the correct CPT code. But are there any other RHC’s out there and how do you keep track of who you can bill for and who you can’t or do you just do it on a claim by claim basis?