Submitted on Tue, 2014-07-29
By SMART Health Claims

Learn the best ways for local health departments to bring in extra revenue by providing vaccines to privately insured patients.

How to Manage Private Stock Vaccines

For years, most health departments have generated revenue by billing public insurers such as Medicaid and Medicare, but with newly insured patients coming from the ACA, health agencies now have the opportunity to add a new revenue stream by billing private insurers. However, not all health departments have been jumping at the new revenue opportunity.

For some, the idea of having to manage and pay for private vaccines is daunting. There has been a fear historically that the cost of the vaccines will be a negative hit to budgets and worse, expired vaccines will be thrown out and money will be wasted.

Managing private stock is not as intimidating as you might think and is a necessary step as VFC stock cannot be used for privately insured patients. Here are a few tips to help you get started:


Examine Your Patient Volume

Knowing what your patient volume is can help you predict how much vaccine you might need to keep on hand. Your patient management systems may have the ability to pull reports on patient volume by services. If you don’t have data, talk to your neighboring health departments to see what kind of insight they can share.


Start with Small Orders

To minimize waste, keep your orders small. Since most vaccine manufacturers offer overnight shipping, you may not need to keep a large inventory in stock. You should be able to replenish your stock quickly when you start running low and some vaccine manufacturers don’t even charge for overnight shipping. This allows health departments to minimize costs and gives you the flexibility to order only what is needed.


Charge Higher Fees

There is potential to recoup on vaccine costs by building a margin on certain vaccines. Health departments can also consider charging a higher admin fee to compensate for wasted vaccines or special program vaccines given to adults.


Increase Your Buying Power

Are you part of a region or a coalition? Are you close with your neighboring health departments? Banding together as a group can enable you to obtain better prices for your vaccines, lowering your costs. You can further increase your buying power if you purchase most of your vaccines from one vaccine manufacturer as opposed to multiple.


Managing private stock is a new territory for some public health departments, but one that is an essential part of developing capacity to bill private insurance companies. The process is manageable and the biggest benefit is that the new revenue stream will enable health departments to continue to provide access to services to those who are truly in need.


Learn More About Building Sustainable Revenue

With funding drops always a threat, public health agencies need to develop a billing program to create the sustainable revenue necessary to maintain/expand staff and services.





local health department billing guide

Innovative Technology Solutions