Flu Shot Vendor Information | HealthPartners

HealthPartners Flu Shot

Vendor Information

2018-2019 Season

The HealthPartners Worksite Health department has an electronic system in place to allow flu shot vendors to efficiently administer and bill for flu shots given to HealthPartners members. The system is a roster-bill system in which:

Vendor collects member information Vendor administers the shot Vendor submits the roster along with an invoice to Worksite Health through a secure portal Worksite Health processes the roster and invoice Vendor receives payment

Under this program, neither flu shot vendors, nor flu shot recipients are involved with submissions or processing of claims but instead Worksite Health completes the process. Our program offers vendors the flexibility to choose how often to submit invoices for payment of shots/injections ? you can submit weekly, monthly or hold everything for a single, end-of-season submission. Two additional advantages are the customer does not need to submit a claim, and the vendor receives payments quickly.

HealthPartners Hospitals and Clinics are exclusively providing the Quadrivalent vaccine to all patients in the 2018 season. HealthPartners and Worksite Health prefer that our flu shot vendors extend the same quality Quadrivalent vaccine to our Health plan members. The Worksite Health team requests that vendors supply all fully insured groups with the Quadrivalent vaccine. Additionally, please thoroughly educate our self-insured groups about the differences between the Trivalent and Quadrivalent vaccines. If the vendor is unable to obtain and supply the Quadrivalent vaccine, and only has Trivalent, we ask that the employer group be informed of the option to obtain Quadrivalent from another vendor. Worksite Health will connect both fully insured and self-insured groups to a vendor who can supply Quadrivalent vaccine (Please have the group reach out directly if you as a vendor are unable to provide the Quadrivalent). The 2018-2019 season is the last season HealthPartners will reimburse vendors for the Trivalent vaccine (cpt 90658). Starting in 2019 HealthPartners will only reimburse for Quadrivalent vaccine.

Following the most recent CDC recommendations, HealthPartners will once again be reimbursing for the FluMist in the 2018-2019 season.

COLLECTING HEALTHPARTNERS MEMBER INFORMATION AT YOUR IMMUNIZATION CLINICS

HealthPartners member ID numbers are 8 digits long. If the number starts with a zero please make sure the excel document holds this zero.

Each member has their own individual member identification number (ID #). DO NOT use the same member ID # for multiple members of a family. Employee, spouse, or dependent(s) who do not know their ID # please call HealthPartners member services at 952-883-5000 to get the correct member identification number prior to administering their vaccine.

If HealthPartners cannot verify the member in our system, we cannot reimburse you. Please check for accuracy when typing member names, birth dates, and member identification numbers.

Spelling counts! Please enter all information accurately. We will return incorrect submissions to the vendor until they are submitted accurately.

VENDOR FLU SHOT ROSTERS

Vendors must submit files as a CSV (comma delimited) (*.csv). Use "save as" and choose the .csv file type prior to submitting. While we try to be as accommodating as possible, our billing system cannot manage rosters submitted in any other data format. Invoices submitted with non-compliant rosters cannot be processed for payment.

Examples of the standard roster data format are provided. Do not add titles, rows, extra text, totals, spaces, etc. Do not alter the spreadsheet in any way. Incorrect spreadsheets will be returned for re-formatting before being processed.

The first column on the roster, "Vendor_ID," is an assigned identifier from Worksite Health. A list of vendor IDs can be found on the vendor website. This ID is not your Tax ID number, address, or anything but the ID we provide. Please use this same ID in every row on each roster you submit.

Worksite Health cannot accept a paper roster or invoice. All documents must be submitted electronically. Rosters must match the invoice. If the invoice is for 25 shots, there must be 25 members listed on the roster

spreadsheet. PLEASE CHECK YOUR MATH.

VENDOR FLU SHOT INVOICES

A separate invoice, with a unique invoice number, must be submitted for each roster. The unique invoice number must match the invoice number listed on the corresponding roster. Unique invoice number means that it is a number that you have NEVER submitted to HealthPartners. A great way to avoid duplicate invoice numbers is to use the date (ie100118 for October 1, 2018).

Please submit invoices as pdf documents. You may invoice weekly, monthly or 1-time batch. Remember invoices must be submitted within 6 months of

the vaccination date. Please do not send 30 rosters and 30 invoices each containing a single vaccine ? please combine whenever possible. The corresponding roster (see above) must be sent with the invoice. Invoices must be sent by email to wshflushot@ through the secure portal. A service date and unique invoice number are mandatory. The invoice lists the quantity of shots by procedure (CPT) code. Total quantity must be listed. PLEASE CHECK YOUR MATH. The invoice should include a subtotal for each procedure (CPT) code and a grand total for the invoice. The invoice should include the vendor's billing contact information, including an email address.

NEW for 2018

SUBMITTING FLU SHOT ROSTERS (.CVS FILE) AND INVOICES (PDF FILE) You will receive an email invitation which contains a link (e.g. "View Folder") that takes you directly to

Upon clicking the link to "View Folder" you will be taken to the following page

o If you do not yet have a box account, click the "Sign Up" button* o Otherwise, select "Not part of HealthPartners" to login and access the shared file

*During the sign-up process, you may need to navigate to the "Individual Plans" section to sign up for a free account:

FEES AND PAYMENT

HealthPartners Reimbursement Rates for 2018-2019 year:

Description

Trivalent Injection (from multidose vial) Quadrivalent injection (from multidose vial) Quadrivalent individual dose injection>3 years

Quadrivalent individual dose injection 6-35 months Quadrivalent individual dose/FluMist Tdap

Pneumococcal vaccine (Pneumovax 23) Pneumococcal vaccine (Prevnar 13)

CPT Code 90658 90688 90686 90685 90672 90715 90732

90670

Reimbursement Rate (per injection) $26 $33 $34 $34 $41 $60 $125

$230

CPT Copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association

*Self-insured groups will be charged an additional $2 administrative fee, please quote accordingly if communicating with a self-insured group.

HealthPartners will not reimburse onsite vendors for administration of high dose flu vaccine. If a member is asking for a high dose vaccine they should be referred to their family practice clinic to receive the vaccine. High dose flu vaccine administered at the member's family practice clinic will be covered.

Rosters and invoices are processed in the order they are received. Please understand that it may take up to 8 weeks to receive payment.

If you have any questions, please contact the HealthPartners Worksite Health Department:

Casey Speaker casey.h.speaker@ 952.883.7525

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