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How do you run your flu shot clinics?
Sep
18
Hello everyone,
This is a multi-question email to all of you preparing to start the "flu
shot season". We will begin the first week of October and are always
looking to improve our process/service to our families.
Would you share the process for administering flu shots in your office.
Here is what we do.
1) If they are here for a visit and need one, we give it.
2) We run recaller on the computer and pull all those who received one last
year plus those diagnosed with a chronic illness since last season. We
xerox approx. 700 letters and send them out via mail to the parent (along
with a copy of the Influenza VIS that they can look at BEFORE they come).
We offer one when they get to our office, but most say they read it at home
and don't want one.
2) We have several days that we have assigned two nurses to run a flu shot
clinic. We can usually get at least 25/hour done (without taxing the other
clerical/checkout staff too much who are dealing with checking out patients
of 7 providers at a time)
3) In years past we have pulled all charts the day ahead, loosened the
immunization record and made notations of any other imms they needed to
catch up with (or looked for PCV7/PPV23 candidates.)
4) We take the chart, call the family back to the room,verify insurance,
chart all information on the immunization record, give the shot, fasten the
immunization record back in the chart and finally file the charts back at
the end of the day (or in between). It is a mad house, but I have to say
our nurses do a really great job.
5) I am looking to streamline this process. What takes the most time is to
have the parent sign the imm record in the room just before giving the shot.
By then most children are not happy with what is happening and the decibels
begin.
How does the process go in your office? We could not get 800+ doses given
unless we held these special clinics. We usually do a Saturday morning and
get 175-200 children immunized, but again there are SO many charts to pull,
to put back, etc.
How many doses have you ordered? How do you deliver them in your busy
office to the children you have called in to get one?
Sorry so long.
Karen Kohlruss RN BSN
Holland Pediatric Associates, P.C.
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How do you run your flu shot clinics?
We send out postcards with flu clinic dates to all high risk patients first.
We then send out to all the "other diagnosis" shots given the past year. We
limit the clinics to about 100 children at each clinic. The rest we put on
our "shot schedule" that we have on Tues, Wed & Thurs. The nurses squeeze
the patients in with the regular scheduled patients. We also give when
patients are here for other things.
Same insurance verification process applies.
----- Original Message -----
From: "margirl"
To:
Sent: Thursday, September 18, 2003 6:59 PM
Subject: How do you run your flu shot clinics?
> Hello everyone,
>
> This is a multi-question email to all of you preparing to start the "flu
> shot season". We will begin the first week of October and are always
> looking to improve our process/service to our families.
>
> Would you share the process for administering flu shots in your office.
> Here is what we do.
> 1) If they are here for a visit and need one, we give it.
> 2) We run recaller on the computer and pull all those who received one
last
> year plus those diagnosed with a chronic illness since last season. We
> xerox approx. 700 letters and send them out via mail to the parent (along
> with a copy of the Influenza VIS that they can look at BEFORE they come).
> We offer one when they get to our office, but most say they read it at
home
> and don't want one.
> 2) We have several days that we have assigned two nurses to run a flu
shot
> clinic. We can usually get at least 25/hour done (without taxing the
other
> clerical/checkout staff too much who are dealing with checking out
patients
> of 7 providers at a time)
> 3) In years past we have pulled all charts the day ahead, loosened the
> immunization record and made notations of any other imms they needed to
> catch up with (or looked for PCV7/PPV23 candidates.)
> 4) We take the chart, call the family back to the room,verify insurance,
> chart all information on the immunization record, give the shot, fasten
the
> immunization record back in the chart and finally file the charts back at
> the end of the day (or in between). It is a mad house, but I have to say
> our nurses do a really great job.
> 5) I am looking to streamline this process. What takes the most time is
to
> have the parent sign the imm record in the room just before giving the
shot.
> By then most children are not happy with what is happening and the
decibels
> begin.
> How does the process go in your office? We could not get 800+ doses
given
> unless we held these special clinics. We usually do a Saturday morning
and
> get 175-200 children immunized, but again there are SO many charts to
pull,
> to put back, etc.
>
> How many doses have you ordered? How do you deliver them in your busy
> office to the children you have called in to get one?
>
> Sorry so long.
>
> Karen Kohlruss RN BSN
> Holland Pediatric Associates, P.C.
>
> This message is from PEDTALK - a Pediatric Focused email discussion
group.
How do you run your flu shot clinics?
Quote from recent message about flu shots: "What takes the most time is to
have the parent sign the imm record in the room just before giving the shot."
Question: Why do you have the parent sign the IM record? Is it required in
your state?
We simply list the date of the VIS and the date the VIS was given to the
parent. No signature required by the parent anymore.
Judy T RN
How do you run your flu shot clinics?
I believe Judy is correct that a signature on the immunization record is not
required. Perhaps this is just carried over from years of doing so. For
imms they sign right underneath the statement indicating that they have read
the VIS or had it explained to them; they understand the benefits and risks;
they have had the opportunity to ask questions and now wish to have the
vaccine for their child. Maybe this is a Michigan statement...I will check
with the local health dept. which is where we got the verbage from. The
health dept. also has them sign.
I have considered doing just as Judy mentioned....not having the parent sign
since it is not really required. That would certainly speed up the process.
How many offices have parents sign on the immunization record for imms? At
this time we have a space for the date, parent/guardian signature and a
space for them to check if insurance pays for any part of vaccine cost or
not.
Do you have parents sign for imms?
Karen Kohlruss RN BSN
Holland Pediatric Associates, P.C.
How do you run your flu shot clinics?
We created printed "stickies" with a place for the date, a place to mark next
to the listed vaccines which ones we are giving, and a short statement
stating they have seen the VIS, understand the benefits and risks, and wish
to have the vaccine given to their child. The parents sign the bottom and we
stick the label directly into the child's record at the end of their visit
note. If they come in only for vaccination (like for a flu vaccine) the
sticker is our documentation for the visit. We do maintain a separate
immunzation record but parents do not have to sign that. During our flu
clinics we can give parents the VIS and stickers to sign while they are
waiting their turns for the flu shots -- saves a lot of time.
Karen Szafran CPNP
> I believe Judy is correct that a signature on the immunization record is not
> required. Perhaps this is just carried over from years of doing so. For
> imms they sign right underneath the statement indicating that they have read
> the VIS or had it explained to them; they understand the benefits and risks;
> they have had the opportunity to ask questions and now wish to have the
> vaccine for their child. Maybe this is a Michigan statement...I will check
> with the local health dept. which is where we got the verbage from. The
> health dept. also has them sign.
>
> I have considered doing just as Judy mentioned....not having the parent sign
> since it is not really required. That would certainly speed up the process.
>
> How many offices have parents sign on the immunization record for imms? At
> this time we have a space for the date, parent/guardian signature and a
> space for them to check if insurance pays for any part of vaccine cost or
> not.
>
> Do you have parents sign for imms?
>
> Karen Kohlruss RN BSN
> Holland Pediatric Associates, P.C.
>
RE: How do you run your flu shot clinics?
When you bill for the flu shot clinics do you do a nurse 99211 visit too or
just the flu and immunization codes? Do you do any vitals or document
anything other than the flu shot information given? (i/e, risk factors, why
shot given and if pt is currently not ill etc?
We give less than 100 flu shots a year so we do have time to make each it's
own appt and bill for a level 1 or 2 sometimes but I can see it getting more
hectic this year with more people wanting it. We had always billed and DONE a
level 1 visit because the reimbursement for just the flu vaccine was sometimes
under cost, so we take the extra minutes to do the things needed to also bill
for the visit to recoup costs. We found that many times last year the ins.
would pay for the visit but not the shot!
I would feel very strange to just bring a pt to the room and bamb there is the
shot, here is the VIS, see ya later!
How do you run your flu shot clinics?
Doesn't the patient complain because of the additional cost
of the office visit (or copay)? Our patients would
probably opt to go to a clinic somewhere if we did that.
When you bill for the flu shot clinics do you do a nurse
99211 visit too or
just the flu and immunization codes? Do you do any vitals
or document
anything other than the flu shot information given? (i/e,
risk factors, why
shot given and if pt is currently not ill etc?
We give less than 100 flu shots a year so we do have time
to make each it's
own appt and bill for a level 1 or 2 sometimes but I can
see it getting more
hectic this year with more people wanting it. We had
always billed and DONE a
level 1 visit because the reimbursement for just the flu
vaccine was sometimes
under cost, so we take the extra minutes to do the things
needed to also bill
for the visit to recoup costs. We found that many times
last year the ins.
would pay for the visit but not the shot!
I would feel very strange to just bring a pt to the room
and bamb there is the
shot, here is the VIS, see ya later!
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How do you run your flu shot clinics?
Interesting discussion...
We never thought of billing for a level I ! We do bill for level I if the
child comes in for a Rocephin or testosterone or quick strep, but never have
for just a flu shot. We simply bill for the vaccine and the administration
fee.
Now I am curious...do any other offices bill for a level l if the child just
comes in for a flu shot?
As a followup to a previous post or concern about the idea of bringing the
family back, giving the VIS, bam giving the injection and off they go...it
really isn't like this at all. The parents are so grateful to be able to
get in quickly. We schedule them every 5 min and rarely get behind. They
are handed the VIS in the waiting room right upon arrival (most will have
received in the mail if they had the shot last year). We chat as they enter
the exam room...i.e. "Everyone healthy today?" "Does your insurance pay?"
etc. etc. The needed questions just sort of flow. It really is slick with
two nurses working together. We allow staff to pick up extra time to help
with these scheduled clinics. Does it cost the office more in wages? You
bet. Is it good PR for families. You bet.
Flu shot season will never be a money maker. Some things we just need to do
because they are the right thing to do to protect the children and families
in our care. I don't think you will find many in our care complain that we
served them too fast...we are careful to keep that personalized touch
present.
Karen Kohlruss RN BSN
Holland Pediatrics
How do you run your flu shot clinics?
If the patient comes in, is given the shot for the nurse and leaves, then I
think you are supposed to just bill the shot and administration fee. If,
however, the weight is checked or blood pressure or whatever, then you
bill the 99211 for nurse service. If the doc sees the patient for whatever
reason (can he get the shot even if he has a cold? or Do you mind just
looking in the ears?) then you bill a 99212 or higher as appropriate. If I
give the shot rather than the nurse, I also bill higher.
Vicki
-------- Original Message -----------
From: "margirl"
To: "Kids Creek Childrens Clinic \(tc- 486528-1\)"
, "Dianna L. Tolen"
,
Sent: Sun, 21 Sep 2003 11:31:43 -0700
Subject: Re: How do you run your flu shot clinics?
> Interesting discussion...
>
> We never thought of billing for a level I ! We do bill for level I
> if the child comes in for a Rocephin or testosterone or quick strep,
> but never have for just a flu shot. We simply bill for the vaccine
> and the administration fee.
>
> Now I am curious...do any other offices bill for a level l if the
> child just comes in for a flu shot?
How do you run your flu shot clinics?
margirl wrote:
> Interesting discussion...
>
> We never thought of billing for a level I ! We do bill for level I if the
> child comes in for a Rocephin or testosterone or quick strep, but never have
> for just a flu shot. We simply bill for the vaccine and the administration
> fee.
We don't schedule special flu hours. We will always see the patient,
usually a brief visit (level 2)--often these kids are asthmatic or have
some other chronic disease--so we review how things are going, listen to
their lungs, etc. In fact, many of these visits are level 3's.
--
Gary M. on LI
DISCLAIMER: Eh, never mind!
RE: How do you run your flu shot clinics?
No, since we have always done it this way they don't know any different. And
we don't have any clinics here that will do children so they know they have to
go to their physician's office for this. We check up on the kids then anyway
so they are really getting a visit too, not just the shot. The only
complaints are because the shot is not covered and we all feel it should be!
>===== Original Message From "Kids Creek Childrens Clinic (tc- 486528-1)"
=====
>Doesn't the patient complain because of the additional cost
>of the office visit (or copay)? Our patients would
>probably opt to go to a clinic somewhere if we did that.
How do you run your flu shot clinics?
Message from Wayne Fellmeth hidden@email-address
We do pretty much the same. We have 11 docs, 3 pnps and 4 offices. We
open one of our satellite offices that is normally closed on a weekend
and run a "shot clinic" for just flu vaccine every Sat in Oct and Nov, a
different office each week. Shots given by appt only and usually are
booked solid (we allow 5 min per shot) We also will have some weekday
and evening times as well in each of the offices and try to catch as many
as we can at regular visits.
We do give vaccine to parents as long as they pay at time of service.
We'll send out about 3500 flu letters this year to get all of our high
risk kids and kids under 2.
Wayne
margirl wrote:
Hello everyone,
This is a multi-question email to all of you preparing to start the "flu
shot season". We will begin the first week of October and are always
looking to improve our process/service to our families.
Would you share the process for administering flu shots in your office.
Here is what we do.
1) If they are here for a visit and need one, we give it.
2) We run recaller on the computer and pull all those who received one last
year plus those diagnosed with a chronic illness since last season. We
xerox approx. 700 letters and send them out via mail to the parent (along
with a copy of the Influenza VIS that they can look at BEFORE they come).
We offer one when they get to our office, but most say they read it at home
and don't want one.
2) We have several days that we have assigned two nurses to run a flu shot
clinic. We can usually get at least 25/hour done (without taxing the other
clerical/checkout staff too much who are dealing with checking out patients
of 7 providers at a time)
3) In years past we have pulled all charts the day ahead, loosened the
immunization record and made notations of any other imms they needed to
catch up with (or looked for PCV7/PPV23 candidates.)
4) We take the chart, call the family back to the room,verify insurance,
chart all information on the immunization record, give the shot, fasten the
immunization record back in the chart and finally file the charts back at
the end of the day (or in between). It is a mad house, but I have to say
our nurses do a really great job.
5) I am looking to streamline this process. What takes the most time is to
have the parent sign the imm record in the room just before giving the shot.
By then most children are not happy with what is happening and the decibels
begin.
How does the process go in your office? We could not get 800+ doses given
unless we held these special clinics. We usually do a Saturday morning and
get 175-200 children immunized, but again there are SO many charts to pull,
to put back, etc.
How many doses have you ordered? How do you deliver them in your busy
office to the children you have called in to get one?
Sorry so long.
Karen Kohlruss RN BSN
Holland Pediatric Associates, P.C.
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