Wiki vaccine refusal

[staceylw31@aol.com]

I work for a pediatric office and we have had instances where we will draw up the vaccines because the parent already said they would get them, but when the nurse walks into the room with them they say no. That vaccine is now wasted. Is there a code that we can bill to get reimbursed for that vaccine? Some of these vaccines are very expensive. If anyone has any advice I would love to hear it!

Stacey

 

[CBLENNIE]

I work for a commercial insurance company and there isn't any way we would pay for the vaccine in this circumstance.

As for advice on how to deal with this situation in the future, have you considered creating a form that the parent/guardian reviews and signs prior to the vaccine being drawn up that indicates that they have consented to the vaccine being administered to the patient. Included on the form would be information regarding what happens if they change their mind and withdraw consent after the vaccine has been drawn from the vial. You would then explain that the once the vaccine is drawn from the vial if it is not administered to the patient, it must be discarded as it cannot be stored for future use, and the responsible party will be liable for paying out-of-pocket for the discarded vaccine because insurance will not cover the cost of the discarded vaccine.

I would suggest that in addition to having a signature line on the form acknowledging receipt and understanding of the practice's policy regarding this subject, I would have a line for them to initial next to the explanation that they will need to pay out-of-pocket so have documentation that the received the information and that they acknowledged that they will be liable for paying out-of-pocket for vaccine(s) that have been drawn from the vial and then discarded due to their decision to withdraw consent for administration of the vaccine.

If you already have some type of consent form for vaccines, you could consider updating it to include some type of language that explains what I suggested above.

You will need to make sure to run this by your compliance and/or legal department(s) to make certain you can implement this type of policy and if so have them review the document containing this information, to again make certain it is compliant with any local/state/federal regulations.

Please note the information/recommendations made in this post are not considered legal advice and as stated above you should consult with your legal department prior to implementing any of the suggestions made above.