COVID-19 vaccination insurance billing varies by local provider
Are you getting or have you already received at least one dose of a COVID-19 vaccine? Your insurance might be billed.
Or it might not.
While the cost of the vaccine itself was covered by the federal government in its mass purchase of vaccines aimed at getting a control on the pandemic, the cost to actually put the shot in people’s arms was not.
That has meant that either Medicare, Medicaid or private insurance companies are being billed to help cover that cost, for those who have it, as in the case of Grand River Health in Rifle, which operates as a public taxing district.
In other instances locally, the vaccine provider is absorbing those costs, as Garfield County Public Health, as well as Valley View Hospital in Glenwood Springs, a private not-for-profit organization, chose to do.
“Vaccines will continue to be administered at no charge,” Valley View Community Relations Officer Stacey Gavrell said. “We have not charged anyone — first or second dose — since we started these clinics in December.”
She further explained, “We view this as a service to the community,” adding, “As we were preparing for the COVID vaccines this summer (2020), we knew that removing as many barriers as possible would be key to vaccinating as many people as possible.”
Though the individual should never have to pay to receive the COVID-19 vaccine, just the act of billing someone’s insurance to cover the administration costs can create a barrier for people to get vaccinated, Gavrell said.
That could be rooted in the belief that an individual’s insurance rates may eventually go up to cover those costs, which is certainly a possibility as the ongoing costs of the pandemic mount.
From a functional standpoint at the vaccination clinics themselves, though, it’s just one less thing to have to factor in to make the process as smooth as possible, Gavrell said.
“To those getting vaccinated, it would be another process that would affect logistics of hosting the hospital clinics,” she said.
Valley View has administered more than half of the vaccines in Garfield County to date.
The remainder have been administered by Grand River Health, as the second largest provider in the county, as well as by Mountain Family Health Centers, Garfield Public Health, Voces Unidas, a handful of smaller medical clinics and private pharmacies, such as those at City Markets stores and Walgreens Drug stores.
Insurance billing practices have varied between those providers.
Grand River, as a public entity, chose to bill insurance for those with Medicare and Medicaid in particular — and for those with private insurance who were willing to provide their insurance information — as a way to recoup at least some of the costs of staging the massive weekly vaccination clinics.
“It takes an incredible amount of manpower every week to put on the large-scale vaccine clinics, which the small administration fee really does not begin to cover,” Grand River CEO Jim Coombs said. “However, the community benefit of Grand River Health assisting in getting the vaccine out to our community is core to our mission, and the right thing to do.”
Also, by agreeing to cover that administration fee with no cost-share obligation to the patient, Medicare, Medicaid and private insurance see the benefit in paying the fee as a way to get the vaccine administered to as many people as possible, he said. “It’s really a win for insurance companies, as well, because it is much more cost-effective for them to pay a small admin fee than to pay for the costly treatment of a COVID patient,” Coombs said.
Even if the insurance company declines to pay, which is possible under some pre-ACA private health plans, “there is still absolutely no cost to the patient,” he said.
On the front end, when a person arrives at the vaccination clinic there is no requirement to present identification, insurance information, or even residency, Coombs said.
Elsewhere, Garfield County Public Health, which has switched to a walk-in format for its weekly vaccine clinics across the county, and Voces Unidas, which stepped up to provide the vaccine to the area’s Latino community, have not been billing insurance.
Mountain Family Health Centers has indicated on its vaccination information web page that insurance may be billed to help recoup costs. City Market has also reportedly been billing for a nominal administration fee for those who have insurance.
Hospitals adjust to lag in vaccine demand
As Garfield County Public Health noticed a recent downturn in demand for appointment-based vaccines at its clinics, prompting a move to a walk-in format, the county’s two hospitals are also making adjustments to their weekly clinics.
“We are noticing a change in our vaccine clinics,” Gavrell said. “Previously, we would announce a vaccine clinic and it would be full within a manner of minutes or hours.”
However, in more recent weeks, she said the Glenwood hospital has had to get more creative with its outreach to fill first-dose clinics. Still, though, nearly every appointment is getting filled, Gavrell said.
“Our staff have been incredible allies in sharing the news of our clinics, and so too have other partners such as our local chambers, government organizations, etc.,” she said.
Clinic times have also been adjusted, including one last week from 5-6 p.m., to reach people who are unable to get away during the normal work day.
“We had people attend the clinic and express their gratitude for the new schedule,” Gavrell said.
In addition, Valley View continues with the practice of making rounds to its in-hospital patients, the Emergency Department and other on-site medical clinics, offering the vaccine to anyone who wants it, Gavrell said.
Grand River in Rifle is continuing with its Friday vaccination clinics, and won’t stop until demand wanes, Grand River Community Relations Director Annick Pruett said.
“Getting the community vaccinated is a top priority for our Board of Directors and leadership,” she said. “We have had some issues getting all of our shipments of new vaccine the last two weeks, but we continue to vaccinate every Friday.”
The recent slowdown, however, will mean an eventual transition for Grand River to providing the clinics when the time is right for those who still want or need a vaccine, she said.
Grand River staff has also been assisting Garfield Public Health with its vaccination efforts in local high schools and other off-site locations, Pruett said.
Senior Reporter/Managing Editor John Stroud can be reached at 970-384-9160 or email@example.com.
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