Arizona Immunization Billing Project

Background: County health departments are constantly looking for resources that will allow them to maintain the current levels of services.  Arizona county immunization programs have historically provided childhood vaccines free of charge even when patients had insurance.  Billing insurance companies for immunizations may be a valuable revenue stream to help offset costs and better serve the community.  The Arizona Partnership for Immunization (TAPI), which is the state immunization coalition, stepped forward to assist counties in developing a unique, centralized insurance billing system. 

Objectives:  1)  To assess the number of insured children utilizing county health department vaccine resources. 2)   To develop, test and evaluate a centralized immunization billing process for county health departments in Arizona that is cost effective and sustainable.

Methods: TAPI developed a pilot billing project with selected Arizona county health departments.  ARRA funds accelerated progress on this project.  TAPI’s billing project submitted medical claims for the vaccine administration fees to insurance companies for the children who receive vaccines at county health departments.

Results: Approximately 32% of county health department patients had Medicaid insurance coverage and 10% had private insurance coverage.  TAPI provided an efficient and centralized billing system for county health departments.  Since 2010, TAPI’s billing project generated over $250,000 for county immunization departments in Arizona.  On average the participating health departments received $14 per insured patient.  The money collected has been able to go directly towards the immunization department’s staff and supplies.

Conclusions: County health departments can successfully bill insurance companies to provide immunization program funding. The insurance plans also benefit in that they are able to maintain accurate vaccine records for their patients when claims are submitted. Significant resources are needed to have a successful billing program.  Other states may benefit from this model which uses the immunization coalition.