[Ohioaap-practicemanagers] 2 nd request RE: Vaccine Payment Problem: Ohio Medicaid Managed Care plans

[Price, Jonathan]

Dear All,.
 Please let me know about your experience with the issues below. I would like to develop a response in the near future. Thank you Dr. Garner for your response.
    Jon Price
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From: Ohioaap-practicemanagers [ohioaap-practicemanagers-bounces at lists.deltaforce.net] on behalf of Price, Jonathan via Ohioaap-practicemanagers [ohioaap-practicemanagers at lists.deltaforce.net]
Sent: Friday, March 25, 2016 10:22 AM
To: 'Edward Freeman (edward at rvpi.com)'; 'camille.graham at cchmc.org'; Andy Garner; Ohio AAP Prctc Mngr Listserv (ohioaap-practicemanagers at lists.deltaforce.net); Combs, Frank
Cc: Pastva, Robert; Melissa Arnold (marnold at ohioaap.org); Tina.steece at kidzdoc.com
Subject: [Ohioaap-practicemanagers] Vaccine Payment Problem: Ohio Medicaid Managed Care plans

We’re hearing about significant (but not new) problems from Central Ohio but need to know how widespread they are, especially in other parts of the state. Please let me know if you’re having ANY of these four problems with any of the Ohio MEDICAID MANAGED CARE PLANS (CARESOURCE, MOLINA, BUCKEYE, PARAMOUNT, UHC COMMUNITY). If you ARE NOT having any of these, I’d like to know that too.

1)      The plan does not tell you or you can’t easily find on its website how it wants you to bill for vaccines or vaccine administration.

2)      The plan does not inform you when it changes how it wants you to bill for vaccines or vaccine admin.

3)      When payment is denied, the plan’s customer service or provider rep won’t tell you how else you could code for vaccines or vacc admin in order to be paid

4)      The plan’s customer service or provider rep won’t get back to you at all about your concerns.

If instead you are having positive, smooth experiences with these, I and the rest of the practice managers listserv want to know that too.
Jon Price, MD FAAP
Cochair, Ohio AAP Pediatric Council
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