Automatic Billing and Vaccines for Children Eligibility Screening

Background:
The Minnesota Vaccines for Children (MnVFC) program is exploring the complexities of electronic billing systems and their effect on eligibility screening. Billing practices are important for two reasons. First, MnVFC uses 317 funding to cover underinsured children for all vaccinations. Many parents do not know the status of their insurance and it is difficult to get up-to-date information on insurance status because other healthcare costs may not have been applied to the account at the time of vaccination. Second, Minnesota has many large providers that use automatic billing systems to process claims. The billing system automatically sends the bill to the patient and in doing so may inappropriately charge an underinsured child for vaccine. The MnVFC program is collaborating with partners to better understand the billing process and beginning to address the issue of underinsured children being incorrectly billed.

Setting:
N/A

Population:
Underinsured children

Project Description:
Staff from the MnVFC Program spoke with several large providers to learn more about the issues arising from the billing process and contracted with billing experts for further analysis. We discovered that insurance coverage is a moving target. Thus education is needed for both parents and billing personnel as it relates to challenges addressing eligibility. The MnVFC program created a promotional campaign to inform parents that they should contact their clinics billing department if they believe they are eligible for MnVFC but have received a bill for vaccine. The MnVFC program also created a form to educate billing offices about MnVFC and prepare them to receive calls from parents.

Results/Lessons Learned:
The promotional campaign is the first step to inform parents and billing personal about MnVFC program eligibility. Next summer we will evaluate if billing office staff have a working knowledge of MnVFC eligibility which will allow us to reshape our messages and recommended procedures.