By LAURAN NEERGAARD
The Associated Press
Friday, February 1, 2008; 8:29 PM
WASHINGTON -- Flu season is in full swing, with wide outbreaks in 11 states _
and a new strain is starting to emerge that this year's vaccine doesn't
specifically target, the government's public health chief said Friday.
People still should get their flu shot, and there's plenty available, Dr.
Julie Gerberding, head of the Centers for Disease Control and Prevention, told
The Associated Press. So far, the majority of flu cases are being caused by
strains that are a good match to the vaccine - and it should provide some
cross-protection against the new bug, too, Gerberding stressed. "We're still very
optimistic" about the protection, Gerberding said. "If people haven't gotten
their flu shot, it really is still not too late."
Every year, the flu infects up to 20 percent of the population, causes the
hospitalization of 200,000 people and kills 36,000. Flu is a virus, but it can
make its victims vulnerable to bacterial infections, in the lungs or the
bloodstream, at the same time.
Children are at particular risk, and the CDC this week sent an alert to
doctors to watch for young flu victims who might also have such bacterial
infections as the notorious drug-resistant staph known as MRSA. Last year, the CDC
learned of 73 children who died from flu, and 44 percent of them had a bacterial
co-infection - mostly staph. Compared to earlier years, that's a five-fold
increase in staph piggybacking on kids' flu. While the CDC's newest flu report
lists one child death so far this year, Gerberding wanted to be sure that
doctors test for staph in any child with a suspicious illness "because these
bacteria need special treatment, and we want to make sure they get the right
therapy."
Each year's vaccine contains protection against three influenza strains _ two
members of the nasty Type A family, an H1N1 and an H3N2 version, plus a
milder Type B _ that experts predict will cause the most illness.
So far this year, H1N1 is causing the vast majority of disease, Gerberding
said. But a new H3N2 strain emerged near the end of Australia's flu season, too
late to be included in the U.S. vaccine. Called H3N2/Brisbane-like, it is now
sickening Americans, although it still is making for a small proportion of
cases, Gerberding cautioned.
Some 132 million doses of vaccine were produced this year, more than ever
before. It's too early to know how many people got vaccinated, but Gerberding
said a record number of doses were distributed to doctors and other vaccine
providers _ and that there is still some available.
CDC has found flu affecting most of the country but widespread outbreaks in
Alaska, Colorado, Hawaii, Kansas, Massachusetts, Mississippi, New Mexico, New
York, Pennsylvania, Texas and Virginia.
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48)
Flu Season
I know this subject has been exhausted but my doctor wanted me to pose
this question.
On the new Flu Mist and flu shots, if we routinely file the patient's
insurance but choose not to for the flu shot or flu mist, have the patient
pay at time of service and offer them a HCFA so that they can file their
own insurance for reimbursement, are we bound to accept what the insurance
pays? Sometimes a parent just wants the shot for "well care". But some
kids we can put a DXS as asthma, transplant, etc.
Dr. Boyd and I are of the impression that if the insurance allows $XX and
we have a contract with the insurance company and the EOB comes back to
the patient that states this allowable, we have to adjust the PPO
discount and accept what insurance pays.
This will be our first year not billing the flu shots.
Thanks for your replys!
--
Debbie MacLeod Children's Clinic of Owasso, P.C.
hidden@email-address 8439 N. 117th E. Avenue
918-272-8989 or fax 918-272-4185 Owasso, OK 74055-2142
Flu Season
I've been watching the flu shot questions/answers and am still confused as to
how practices that have a contract with an insurance company can refuse to
submit the claim and make the patient pay FFS. I loved the idea!! My clinical
nurse wanted me to implement it here. However, my gut feeling was that I
could not do this and a couple of my insurance carriers confirmed that. Our
contracts obligate us to bill the insurance company. So, we will continue to
bill to the insurance carriers.
Barb Carlisle
Holland Peds
Debbie MacLeod wrote:
> I know this subject has been exhausted but my doctor wanted me to pose
> this question.
>
> On the new Flu Mist and flu shots, if we routinely file the patient's
> insurance but choose not to for the flu shot or flu mist, have the patient
> pay at time of service and offer them a HCFA so that they can file their
> own insurance for reimbursement, are we bound to accept what the insurance
> pays? Sometimes a parent just wants the shot for "well care". But some
> kids we can put a DXS as asthma, transplant, etc.
>
> Dr. Boyd and I are of the impression that if the insurance allows $XX and
> we have a contract with the insurance company and the EOB comes back to
> the patient that states this allowable, we have to adjust the PPO
> discount and accept what insurance pays.
>
> This will be our first year not billing the flu shots.
>
> Thanks for your replys!
>
> --
> Debbie MacLeod Children's Clinic of Owasso, P.C.
> hidden@email-address 8439 N. 117th E. Avenue
> 918-272-8989 or fax 918-272-4185 Owasso, OK 74055-2142
Flu Season
Debbie,
This plan may work with the insurance companies you are not under contract
with, but not your contracted companies. How do you code your flu shots for
both procedure and diagnosis?
Lydia@cppa
Flu Season
Debbie, we bill insurance but there are doctors that do not bill
insurance but have the patient sign a letter that states patient will
not file with their insurance..I know the ENT across the hall from us
does this and
his office manager says they have no problems..I know they are not a PCP
but same concept..
Debbie MacLeod wrote:
>I know this subject has been exhausted but my doctor wanted me to pose
>this question.
>
>On the new Flu Mist and flu shots, if we routinely file the patient's
>insurance but choose not to for the flu shot or flu mist, have the patient
>pay at time of service and offer them a HCFA so that they can file their
>own insurance for reimbursement, are we bound to accept what the insurance
>pays? Sometimes a parent just wants the shot for "well care". But some
>kids we can put a DXS as asthma, transplant, etc.
>
>Dr. Boyd and I are of the impression that if the insurance allows $XX and
>we have a contract with the insurance company and the EOB comes back to
>the patient that states this allowable, we have to adjust the PPO
>discount and accept what insurance pays.
>
>This will be our first year not billing the flu shots.
>
>Thanks for your replys!
Flu Season
> Debbie,
We are making the Flu Mist FFS. We will file and only refund the amount actually paid
by the insurance company. We have the parent fill out a form/waiver explaining this
and will only administer if they agree to our terms.
The vaccine itself we will file and again based on our terms bill them for the difference.
We have used this type of waiver in the past with a Blue Shield and routinely for
some Medicaid patients and so far no problems with either plan.
Linda Smith
WGPP
>
> I know this subject has been exhausted but my doctor wanted me to pose
> this question.
>
> On the new Flu Mist and flu shots, if we routinely file the patient's
> insurance but choose not to for the flu shot or flu mist, have the patient
> pay at time of service and offer them a HCFA so that they can file their
> own insurance for reimbursement, are we bound to accept what the insurance
> pays? Sometimes a parent just wants the shot for "well care". But some
> kids we can put a DXS as asthma, transplant, etc.
>
> Dr. Boyd and I are of the impression that if the insurance allows $XX and
> we have a contract with the insurance company and the EOB comes back to
> the patient that states this allowable, we have to adjust the PPO
> discount and accept what insurance pays.
>
> This will be our first year not billing the flu shots.
>
> Thanks for your replys!
>
> --
> Debbie MacLeod Children's Clinic of Owasso, P.C.
> hidden@email-address 8439 N. 117th E. Avenue
> 918-272-8989 or fax 918-272-4185 Owasso, OK 74055-2142
RE: Flu Season
The only way to get around the insurance contract issue is to have the
patient sign a form that says that they are aware of this and agree to
pay FFS. If they really want to file a claim for reimbursement on their
own, we will warn them that a lot of insurances do not cover it and that
they will not get much back at all.
Gena Ross
Practice Administrator
Rockwall Pediatrics
Rockwall, Texas
-----Original Message-----
From: hidden@email-address [mailto:hidden@email-address] On
Behalf Of Debbie MacLeod
Sent: Friday, September 19, 2003 10:12 AM
To: Partner Talk
Subject: Flu Season
I know this subject has been exhausted but my doctor wanted me to pose
this question.
On the new Flu Mist and flu shots, if we routinely file the patient's
insurance but choose not to for the flu shot or flu mist, have the
patient
pay at time of service and offer them a HCFA so that they can file their
own insurance for reimbursement, are we bound to accept what the
insurance
pays? Sometimes a parent just wants the shot for "well care". But some
kids we can put a DXS as asthma, transplant, etc.
Dr. Boyd and I are of the impression that if the insurance allows $XX
and
we have a contract with the insurance company and the EOB comes back to
the patient that states this allowable, we have to adjust the PPO
discount and accept what insurance pays.
This will be our first year not billing the flu shots.
Thanks for your replys!
--
Debbie MacLeod Children's Clinic of Owasso,
P.C.
hidden@email-address 8439 N. 117th E. Avenue
918-272-8989 or fax 918-272-4185 Owasso, OK 74055-2142