What is a company-sponsored flu clinic?
A company sponsored flu clinic is an event during which the employer group hires certified nurses to set-up an on-site “clinic” to offer their employees an opportunity to become immunized without having to leave the office. The CDC recommends a yearly flu vaccine as the first and most important step in protecting against flu viruses.
All Flu clinics are for the Trivalent Seasonal Influenza (Quadrivalent, Flu Mist and “High Dose” vaccine versions will not be available at these onsite clinics).
HPHC offers on-site flu clinics through a third-party vendor, Maxim.
Who is eligible to receive the shot?
Vaccines can be provided to employees and their families aged 18 and over.
Children 4 years and above can receive the vaccination, provided they have a signed consent from a parent/guardian. The 2nd Flu booster shots indicated for children under age 9 would be deferred to the child’s PCP.
Each participant must fill out a consent form (provided at the clinic) prior to receiving the shot.
When are the flu clinics scheduled?
Clinics will run September 9 to December 31, 2015. Maxim needs a three week lead time from the date you submit a request to schedule a flu clinic.
How much does it cost?
Flu shots are $25 each, but are a covered benefit for Harvard Pilgrim Health Care (HPHC) members who present their HPHC ID card at clinic. Shots are covered up to their benefit limits and will be processed via claims.
The participant will receive an individual bill from Maxim if the participant’s policy carries a co-pay or cost share for flu shots, or if the policy number is not accurate or legible on the form. In this case, the participant must work with Maxim directly to resolve, as it may just require resubmission of the legible ID #. Clinic staff does not have the ability to look up insurance numbers electronically or on rosters.
Participants who do not show a valid, accepted insurance card at the time of the shot and all non-members are individually responsible for the $25.00 shot fee at the time of service. (Cash or Check payable to Maxim.)
Influenza shots provided by HPHC will not be reimbursable through Medicare and/or Medicaid. HPHC will not be able to invoice Physician’s Offices.
Claims + Cash is the only funding option available this season and is most beneficial as flu shots are covered under MMCRA. Fees for all shots must go through insurance or be paid out of pocket by the individual or the company at the time of the clinic. Employer Health is not able to invoice accounts for shot costs. Participants who pay out of pocket will be given a receipt so that the participant may seek possible reimbursement from their carrier.
Other Pertinent Info for Employers
- All clinics have a 25 shot minimum per day per location. Accounts holding clinics with less than 25 shots requirement will be responsible for the difference up to the 25 shot minimum. Example: A clinic has 19 participants. The account will be billed for $150.00 (the cost of 6 shots to meet the 25-shot minimum). This applies regardless of the funding method chosen by the account.
- As with all of our screenings, we cannot provide employer groups with a detailed list of employees that participate for billing or other inquiries as this violates HIPAA privacy rules.
For assistance in setting up your flu clinic, please email Danielle Pepin at danielle.pepin@hrknowledge.com.
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