Aetna (NYSE:AET) is providing free electronic roster billing for pharmacies and other non-traditional providers to use when submitting claims for the administration of the H1N1 flu vaccine. Health plan members receive coverage for H1N1 immunizations under their medical benefit, not as part of their pharmacy coverage, and typically, pharmacies are not able to bill for medical services. However, with “mass immunizers” including pharmacies, community centers, and health clinics now authorized to administer the H1N1 vaccine, Aetna has adjusted its claims processing and payment policies to accept claims for the administration of the H1N1 vaccine from these providers and facilitate the prompt and accurate payment of these claims.
“Accepting roster billing is yet another example of Aetna’s continuing efforts to remove barriers to vaccination for our members, and eliminate administrative complexity that could hinder access,” said Bill Fried, MD, Aetna’s medical director heading the company’s pandemic flu response initiative. “Our goal is to support members by being flexible so they can obtain the H1N1 vaccine at a convenient location. Likewise, we are extending this flexibility to the health care professionals who are taking on the task of administering the vaccine to our members as part of the national effort to respond to the H1N1 flu pandemic.”
Roster billing is a simplified process that makes it easier for mass immunizers to bill health plans in bulk by submitting a single claim with a list of health plan members they have immunized, rather than filling out separate paperwork for each individual they vaccinate. Aetna has contracted with ZirMed® to provide electronic roster billing for administration of the H1N1 vaccine. Providers will access ZirMed’s website to enroll in the program, download the Excel template roster bill, and then upload the completed rosters electronically. Pharmacies that already have a process in place with a vendor to file individual electronic medical claims may continue to do so. Providers who are unable to submit H1N1 vaccine administration claims electronically can print a paper copy of the roster bill and mail it to Aetna. Aetna has established a dedicated P.O. Box to accept paper billing rosters for the H1N1 vaccinations. Additional information on how providers can bill Aetna for administration of the H1N1 vaccine is available on the fact sheet posted on the healthcare professionals section of Aetna’s website. http://www.aetna.com/pharmacy-insurance/healthcare-professional/H1N1_billing.html
Aetna Offers Free CME Courses on Flu Preparedness
Aetna is offering physicians a free CME course that provides information and resources to help them prepare for the pandemic flu or similar health crisis. The CME for physicians entitled "Pandemic Flu: Aware and Prepared CME" is a one-hour course. The course is available online at AetnaEducation.com, Aetna’s education site designed specifically for health care professionals.
Physicians who complete the course can earn one category 1 credit toward the AMA Physician’s Recognition Award. All other health care professionals, including office staff, who complete the course will earn a non-physician certificate.
Aetna Continues to Reach out to Members to Encourage Vaccination