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How many immunizations are missed by billing systems?
Maureen S. Kolasa1, David P. Reyes1, Janet Ellis Cherry2, Andrew Chilkatowsky3, and James P. Lutz4. (1) National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Rd E52, Atlanta, GA, USA, (2) Division of Disease Control, Immunization Program, Philadelphia Department of Public Health, 500 S Broad St, 2nd Floor, Philadelphia, PA, USA, (3) Immunization Program, Division of Disease Control, Philadelphia Department of Public Health, 500 S. Broad St, Philadelphia, PA, USA, (4) Division of Disease Control/ Immunization Program, Philadelphia Department of Public Health, 500 South Broad Street, 2nd Floor, Philadelphia, PA, USA
BACKGROUND:
Billing systems often supply information to immunization registries. Billing data, however, sometimes fail to capture all or some immunizations given during a visit, resulting in incomplete information in the registry.
OBJECTIVE:
Among providers submitting electronic billing data to Philadelphia’s KIDS immunization registry, assess differences between immunizations administered and immunizations recorded in their billing systems.
METHOD:
Forty-five providers (8 public health clinics, 7 Federally Qualified Health Centers, 11 family practices, 8 pediatric practices and 11 hospital-based clinics) each served > 50 children aged 7-35 months and used electronic billing systems to report immunization data to the registry in 2003. Philadelphia’s Department of Public Health (PDPH) used the registry to identify all children not up-to-date for immunizations. PDPH conducted chart audits for all children identified as not up-to-date. Chart records were compared to registry records to identify immunizations not reported to the registry by electronic billing systems.
RESULT:
Among the providers submitting electronic billing data, 20,611 children aged 7-35 months were identified as not up-to-date for immunizations. Among these children, 194,496 (76%) immunizations were recorded into the registry via the provider’s billing system. Another 62,473 (24%) immunizations were given by the provider but were not entered into the billing system.
CONCLUSION:
Electronic billing data did not capture many immunizations administered by these providers. As a result, registry data were incomplete. For providers who submit billing data to immunization registries, improvement of billing data quality will result in a more complete registry, higher reported immunization coverage rates, and recovered revenue for the immunization provider.
LEARNING OBJECTIVES:
Attendees will understand that improvement of electronic billing data will result in improved data quality in immunization registries.
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