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Neighborhood Health Plan of Rhode Island 2013-2014 OSCIA Immunization Reimbursement Workshop

Neighborhood Health Plan of Rhode Island 2013-2014 OSCIA Immunization Reimbursement Workshop. Immunizations and Vaccines. Influenza/Pneumococcal Billing & Reimbursement Administration Coding Pediatric and Adult State Supply

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Neighborhood Health Plan of Rhode Island 2013-2014 OSCIA Immunization Reimbursement Workshop

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  1. Neighborhood Health Plan of Rhode Island2013-2014 OSCIA Immunization Reimbursement Workshop

  2. Immunizations and Vaccines • Influenza/Pneumococcal Billing & Reimbursement • Administration Coding • Pediatric and Adult State Supply For more information regarding vaccines please go to our website: www.nhpri.org/Providers/Resources & FAQs/ Please refer to the RI Department of Health Pediatric and Adult State-Supplied Vaccine Guidelines

  3. 2013-2014 Influenza/Pneumococcal Billing & Reimbursement • Children, 6-35 months • 90655 • Children, ages 0-18 years of age • 90670 • 90732 • 90686 • 90672 • Adults, 19-65 • 90656 • 90658 Please refer to the RI Department of Health Pediatric and Adult State-Supplied Vaccine Guidelines Neighborhood Website: http://www.nhpri.org/Provider/Resources & FAQs

  4. 2013-2014 Influenza/Pneumococcal Billing & Reimbursement • Vaccine Administration Coding 0-18 years old • 90460 • 90461 • Vaccine Administration Coding all ages • 90471 • 90472 • 90473 • 90474 • 90471 & 90473 will bundle and deny if billed together on the same day Please refer to the RI Department of Health Pediatric and Adult State-Supplied Vaccine Guidelines Neighborhood Website: http://www.nhpri.org/Provider/Resources & FAQs

  5. Common Billing Errors/Non Covered Vaccines After 7-14-13 two previous codes that were State Supplied will no longer be covered by NHPRI • 90648-act HIB Vaccine • 90660-Flu Vaccine A full list can be located: www.nhpri.org/Providers/Resources & FAQs/ Please refer to the RI Department of Health Pediatric and Adult State-Supplied Vaccine Guidelines

  6. Primary Care Charles Scaletta, Manager, Primary Care Network cscaletta@nhpri.org 401-459-6098 Provider Services Nancy Butera, Community Health Center Consultant nbutera@nhpri.org 401-459-6108 Ian Evans, Primary Care Services Consultant ievans@nhpri.org 401-459-6090 Bethany Wingren, Primary Care Services Consultant bwingren@nhpri.org 401-459-6660 Provider Engagement and Contracting

  7. Telephone Directory • Claims Department/Member services 401-459-6020 or 800-459-6019 Navivet: https://connect.navinet.net • Member Eligibility • Claim Status Inquiries • Links to Important Notifications Neighborhood Website: http://www.nhpri.org

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