In recent years, physician billing/software vendor athenahealth Inc. has mined its claims data to create an annual PayerView report ranking the performance of ambulatory insurers. It's now mined data on vaccine reimbursements, and finds they fall short.
The Watertown, Mass.-based vendor's VaccineView report shows physicians are being under-reimbursed for certain vaccines about 47 percent of the time. The results are based on data from 158,983 individual charge lines from January 2009 through December 2010, submitted by 1,427 physicians and billed to 48 governmental, regional and national payers.
Evaluated vaccines included influenza, chicken pox, measles, mumps, rubella, HPV and diphtheria/tetanus/pertussis. Providers shoulder the cost to stock these vaccines, but incur additional costs that bring the total cost to 17 to 28 percent above the vaccine price, according to the American Academy of Pediatrics. These add-on costs include personnel to order and inventory, and storage and insurance vaccine losses, among other factors.
The report is available at athenahealth.com/Vaccineview. Registration is required.
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