I give up trying to get the kids flu shots !!!

[kilee]

Wanted to respond to this thread.......I am in NY- WNY too to be exact. I work for a large medical clinic in Buffalo.

In NYS pediatric providers get 2 supplies of vaccines. There is the supply we buy and then provide to patients w/ commerical and private insurances. We then get to bill the insurance company for reimbursement of the vaccine.

There is then the VFC supply (Vaccine For Children) that gets provided to peds offices free of charge. We CANNOT bill for this immunization. It is for children who are on Medicaid, Child Health Plus, or uninsured.

That is pathetic that welfare (you are on welfare if you accept taxpayers' forced donations) folks get to jump ahead of the line once again.

The actual truth is that most offices in the area received their private supplies in late August and early September. Meaning most of those doses were gone by the 3rd and 4th weeks of September due to a higher demand this year caused by a flu panic.

In turn, children who are on the VFC insurances HAD to wait until their supply came in from the state, which was just recently done. So in reality the patients w/ private insurances actually got their shots a good 4-6 weeks earlier than the Medicaid/state funded insurance patients.

The problem is now that the private supply manufacturers are out...and more cannot be found. It really is a learning lesson to start calling in early September no matter what the insurance to find out when your provider will have it.

The other thing I wanted to comment on is about Child Health Plus being referred to as a "welfare plan". Here in NYS ANY uninsured child is eligible for Child Health Plus. Granted some receive it for free, but many of the policies are actually paid for monthly. The coverage is better than most employers offer and usually costs less. So, really it is something that all parents should look into. It includes a full dental plan, $0 copays, and full vision coverage.

 

[kilee]

The lack of or refusal of shots is a choice made by the drs. office, not mandated from the state.

This statement is 100% incorrect w/ the way the VFC program works here in NYS. We CANNOT give the VFC supply out to private insured patients.


To the original OP-- our clinic has an overstock of the seasonal flumist. So depending on if your kids can get the seasonal flumist we are a community provider to give the immunization for anyone w/ Community Blue, Blue Cross, or IHA-- not Univera. If you're interested PM me for more info. We don't have any seasonal flu shots left. I know you said WNY, but not sure how close to Buffalo you are.

 

[HelenePA]

This statement is 100% incorrect w/ the way the VFC program works here in NYS. We CANNOT give the VFC supply out to private insured patients.

I'm the other person with the flu shot thread.. thought I'd pop on by.. I have a question about this.. can you give out private insurance shots to non private insurance people? I'm just curious how it work for you

 

[DancingBear]

Deleted

 

[kilee]

HelenePA-- NO- we have a private supply and a state supply. We cannot give the state supply to privately insured patients.

The reversal is we could give a private supply flu shot to a medicaid patient. HOWEVER, we take a loss. We paid for that private supply flu shot, and if we do this we CANNOT bill anyone (patient or insurance) for that shot. If we did that even 100 times we'd have a loss of over $1000.

I think the one thing to keep in mind for anyone upset over the politics of this is the reimbursement. In reality the state could not provide us w/ the flu shots and then let us charge them for reimbursement. However, they get them at a much better discount, so it's actually cheaper for them to purchase and give to us to administer to the patients on state funded programs.

 

[Nancy]

Since the CVS is a "clinic" of sorts and it is considered an office visit, our insurance pays for the shot. They don't pay if we go to Target or Costco or any other stores that just give shots. We ended up paying $6.00 of the $30 fee.

Right, CVS has the mini clinics that are permanent fixtures..so they have tax id numbers and can bill insurances. Those flu shot clinics that set up in different locations on a day to day basis will not have the same thing. So you pay up front and then send a manual claim for reimbursement. With my insurance that would be considered out of network and would apply to my deductible and co insurance...if I would get the shots at my doctors or CVS or any place that bills with an office place of service code it would be covered at 100 % if they are in network.

 

[Pin Wizard]

I doubt you would have better luck getting a seasonal flu shot in VA. DS had an appointment for his, and the doctor's office called and cancelled saying they were out, were supposed to receive a shipment two weeks prior and it didn't show up. They're hoping to reschedule in November. Hmmmmmmmmmmmmmmm.

 

[Tinker'n'Fun]

This statement is 100% incorrect w/ the way the VFC program works here in NYS. We CANNOT give the VFC supply out to private insured patients.


To the original OP-- our clinic has an overstock of the seasonal flumist. So depending on if your kids can get the seasonal flumist we are a community provider to give the immunization for anyone w/ Community Blue, Blue Cross, or IHA-- not Univera. If you're interested PM me for more info. We don't have any seasonal flu shots left. I know you said WNY, but not sure how close to Buffalo you are.

You are 100% correct, I just did not get my point across through words. I took the OP's original quote that the Drs. office had "purchased" the immunization and was being forced to give those shots to CHP patients. I was not able to put into words what you did perfectly.