Vaccines for Children

Frequently Asked Questions (FAQs)

Enrollment

Why should I enroll?

For several reasons:

• No out of pocket expense
• You can offer over $500.00 of free vaccine for each eligible child
• No need to refer patients to public clinics for free vaccines
• You can continue to decide who you see in your practice
• Enrollment, screening and distribution are simple
• VFC is helping to ensure the physician's office serves as the child's medical home

How does the program work?

Once your practice is enrolled, we will provide vaccine free of charge for all eligible children that may visit your practice. Here's how it works:

1. Document patient eligibility 
   A child's eligibility is recorded on the Patient Eligibility Screening Record and maintained in the patient's chart, your computer billing system or a central location of your choosing.
2. Track vaccine administration and wastage/loss
   A record of vaccines administered is maintained by using the Vaccine Usage Tally Sheets provided by the VFC Program. A separate tally sheet is used for each VFC eligibility category. For example, all Medicaid-enrolled children are listed on the same tally sheet each month. These sheets are designed to make it easier for your practice to keep track of and tally usage. They do not have to be sent to our office, but should be kept on file in yours. The Comprehensive Report is a record summarizing your practice's vaccine usage, vaccine wastage, and inventory on hand. (All wastage must be reported monthly, complete with reason code, lot number, and expiration date information.) Personalized Comprehensive Report forms and Personalized Vaccine Usage Tally Sheets will be sent out in a follow up package mailed to your office. Samples of the Comprehensive Report and Usage Tally Sheets have been enclosed in this packet for your reference.
3. Submit report of vaccines administered
   Submit the Comprehensive Report to our office once a month, at any time during the month. When our office receives and processes your Comprehensive Report, we will replenish your vaccine stock with enough vaccine to keep you at a three-month supply. During times of vaccine shortage, allotments will be adjusted according to vaccine availability.

Vaccines are packed and shipped on Mondays, Tuesdays, Wednesdays and Thursdays. Vaccines are delivered to you on Tuesdays, Wednesdays, Thursdays and Fridays, except for holidays. Once your completed enrollment forms are received, you should receive vaccines within seven to ten business days. It is essential that you notify us promptly of any special shipping instructions such as restricted delivery days, or changes in office hours or delivery address, in order to avoid vaccine loss.

How do I enroll?

If you wish to participate in the Vaccines for Children Program, please review the Agreement Policy, Vaccine Loss Policy, and the Fraud and Abuse Policy listed below. Items with an asterisk (*) must be submitted to the program to begin the enrollment process.

1. Enrollment Introduction Letter
2. Equipment Requirements
3. VCF Agreement Policy
   These are the conditions that are agreed to when a provider signs the Provider Agreement form.
4. Accountability Policy- Revised April 2012
5. Vaccine Loss Policy - Revised April 2012
   These are the policies for management of incidents that result in a loss of VFC vaccine.
6. Fraud and Abuse Policy - Revised 2012
7. Provider Agreement Signature Page*
   Please make sure all physicians, nurse practitioners, nurse midwives and physician's assistants in your practice read and sign the Provider Agreement. Professional licenses of the mentioned individuals must be submitted with the Provider Agreement. All staff must read the Provider Agreement Policy and Vaccine Loss Policy prior to signing this form. Keep in mind that signatures of all new providers/physicians added to your practice after initial enrollment must be added to this agreement, and the agreement faxed to the VFC office.
8. Provider Profile and Enrollment Form*
9. Vaccine Order Form* - Revised April 2012
   Complete in order to receive your first vaccine shipment. Our standard of practice is to send 10 doses of each vaccine to newly enrolled providers. If you need more than this amount, please contact us and provide justification for the additional doses needed. Please mark "0" for any vaccines you do not wish to receive. This form should only be completed for your first vaccine shipment or for special immunization initiatives, such as health fairs.

How long will it take to get the vaccines after we send in our enrollment application?

We process enrollment applications on a daily basis. Once we receive your application, it is entered and you are sent a more substantial Enrollment Packet (II). Also, your local Immunization Program Consultant (IPC) will be notified. You will receive a call from your IPC to set up a meeting during which your refrigerator and temperature monitoring equipment will be reviewed and you will be given a chance to ask any questions and to review VFC policies. Once the IPC notifies us that your practice has been approved, your vaccines will be shipped out. You should receive your vaccine shipment seven to ten business days after your completed enrollment is received at our office.

I don't know how many children we will see in a year. How do I complete this section on the Provider Profile and Enrollment Form?

We realize that many practices are not able to calculate this information and ask for your best estimate as to how many children will be seen in your practice in a year. If your estimate is too high or too low, it may be changed at any time.

Which forms must be completed?

In order to become enrolled in the Vaccines for Children Program, your office must complete the Provider Agreement and the Provider Profile and Enrollment Form. All medical personnel who wish to enroll must read the Provider Agreement Policy, Vaccine Loss Policy, and Fraud and Abuse Policy prior to signing the Provider Agreement. The signed Provider Agreement and a copy of each provider's medical license must be included with your enrollment application. The Order Form helps guide your initial order. All subsequent orders are based on replenishment rather than on provider orders, though a provider may always request an increase or decrease in shipment amounts.

VFC Provider Requirements at a Glance

VFC provides vaccine free of charge to enrolled providers. This program allows patients to receive well child checkups in their primary physician’s home. Our goal is to assist enrolled sites with management of state supplied vaccines. To assist your site with cutting losses and maintaining active enrollment in VFC, please review the following provider requirements with your staff:

1. Providers must report usage, inventory, wastage, and short dated vaccines on the VFC Monthly Comprehensive Report. This report must be submitted once per month to remain active in the program. Non-compliance may result in termination from the VFC Program.
2. Providers are required to report upcoming expiring vaccines 90 days prior to expiration. Per the VFC Loss Policy, providers are required to report expiring vaccines 90 days prior to expiration so that we may attempt to transfer the doses to another location prior to expiration. This requirement cuts back on vaccine wastage and therefore saves the program money.
3. Physicians and nursing staff signed to the provider agreement are responsible for the overall management of VFC supplied vaccines. Changes in staff, breaks in servicing patients, vacation, temperature excursions, power outages, etc should be reported to the VFC Program to avoid corrective action which may result in replacement of state supplied vaccines or termination from the program.
4. All doses must be accounted for including wasted and expired doses. VFC vaccine should not be discarded. Exemptions to this rule include expired/wasted multi-dose vials or expired/wasted syringes. Both however, must be reported on the McKesson Return Form.
5. The VFC Administrative Office is available to assist you with your needs from 8am-5pm Monday – Friday. Providers may contact the VFC Administrative Office at (404) 657-5013 or gavfc@dhr.state.ga.us. Your Immunization Program Consultant (IPC) is also available to assist you with hands on training. IPC’s may be contacted by calling the VFC Administrative Office.

Remember, if in doubt, call VFC. Calling for help may save your office from costly vaccine replacement. We are here to help!

Patient Eligibility

Is it necessary to complete the Patient Eligibility Screening Record each time a child is seen in our office?

No. You only complete the Patient Eligibility Screening Record once, unless the child's eligibility status has changed. Parents should be asked if their child's eligibility status has changed each time they visit your office. If the child's status has changed, your office will need to update the Patient Eligibility Screening Record.

Is our office required to verify the insurance status of each child participating in the VFC Program?

No. You only complete the Patient Eligibility Screening Record once, and update it each time the child is seen for vaccinations by your practice. Parents should be asked if their child's eligibility status has changed each time they visit your office. If the child's status has changed, your office will need to indicate the change on the line corresponding with that date’s visit.

Is a child that only has a limited amount of immunization coverage on their insurance plan (for example, $100 or less) eligible for vaccines through the VFC Program?

Once a child has reached or exceeded his/her insurance coverage cap on vaccines, the child is then classified as "Underinsured" and, therefore, eligible for vaccine supplied by the VFC Program. It should be noted that a child with this type of coverage will become ineligible for VFC vaccine at the beginning of each new year, until coverage caps have been reached.

What if a child has insurance coverage that only pays for certain vaccines and not all vaccines?

The child would be considered "Underinsured" for those vaccines not covered by the insurance policy. Those vaccines should be administered out of VFC stock.

We have had several situations involving a child that is fully insured but there is a high deductible to be met on the insurance policy before the insurance company will pay. Is this child eligible for VFC because of the deductible?

No. The child is still considered "Fully Insured" and cannot receive VFC vaccine. The parent will be responsible for paying for medical services billed prior to the deductible being met.

Vaccine Reporting

When do we send in the Comprehensive (Vaccine Usage and Inventory) Report?

The Comprehensive Report must be submitted every month in order for your office to receive a vaccine shipment. The importance of this report is that it details your practice's usage and inventory, which is crucial for your practice's vaccine accountability. This report may be submitted at any time during the month, but only once during the month. Monthly reporting allows us to keep your office stocked adequately with VFC vaccine.

How does your system calculate how much vaccine to send us based on our Vaccine Usage Report?

The Georgia VFC Program operates on a replenishment system. Providers should maintain a 2-3 month supply of vaccine as a cushion to avoid missed opportunities to vaccinate. The difference between your three month need and your reported inventory is your recommended vaccine shipment.

Do I need to send in an Inventory Report with my Vaccine Usage Report each month on the Comprehensive Report Form? Do I need to send in a Vaccine Order Form with my Comprehensive Report each month?

All portions of the Comprehensive Report (Usage, Wastage, and Inventory) are required. This helps ensure that your office receives the maximum amount of vaccines possible in the event shots were inadvertently not recorded at the time of administration. This also helps to protect your practice from having poor vaccine accountability due to "unaccounted for" vaccines.

A Vaccine Order Form should only be submitted for your initial order after enrollment or when you know you will use more vaccine than usual (e.g., for recalls, health fairs, or increased enrollment).

If I send in my Comprehensive Report today, how soon will I receive my shipment?

Usually you will receive your vaccines within seven to ten business days from the date your Comprehensive Report is received by our office.

Why is there a form to report vaccine usage for Private Pay patients?

The Private Pay Usage Tally Sheet is included in your packet in an effort to reduce the number of times information is recorded in your office. We hope the inclusion of the Private Pay form will allow your office to use the VFC forms as your primary log for all vaccines given in your practice.

How do I get more copies of the Comprehensive Report?

There is a master set of the Comprehensive Report and Tally Sheets in each provider’s enrollment packet. Please make copies from this master set. In the event you run out of reports, contact our office and we will send you more.

Vaccines

Is there any special type of refrigerator or freezer I need to have to store the vaccines?

The units must be able to meet certain temperature guidelines:

• The refrigerator compartment must maintain temperatures between 35º and 46ºF (2º and 8ºC).
• The freezer compartment must maintain the temperature at 5º F (-15º C) or colder
• Household-style units must have separate thermostat/temperature controls for the refrigerator and freezer.
• Both the refrigerator and freezer compartments must contain an NIST-or ASTM-certified thermometers.

However, there are options within these guidelines. If both refrigerator and freezer are contained within one unit, there should be a separate door for each of those sections. Both household and commercial types of such units are acceptable. Dormitory-style units are not approved for storage of any vaccines.

What should I do if I receive warm or damaged vaccines?

You should call our office IMMEDIATELY at 1-800-848-3868. We will be able to help you determine if the vaccine is still viable and generate a replacement shipment if needed. Vaccines should be placed back into the proper storage temperature as quickly as possible. Vaccines should not be discarded prior to calling our office to determine viability.

We receive the same vaccines but from different manufacturers through the VFC Program. Why does this happen and what should we do if we start a child using one brand of vaccine but receive another in the middle of completing the series?

The vaccines for the VFC Program are purchased through contracts negotiated through the Centers for Disease Control and Prevention (CDC). The CDC contracts for vaccine purchase from each vaccine manufacturer. The vaccines are then shipped to our providers by McKesson from their distribution center in Memphis, Tennessee.

According to the ACIP, the administration of one vaccine type from different manufacturers will not affect the efficacy of the vaccine administered to a child in the past. If you do not know what brand of vaccine a child has received or do not have that particular brand in your inventory, you should use the vaccine you have in stock.

What do I do if I have vaccines that are about to expire or have expired?

It is our desire in Georgia to have "0" doses of expired vaccine. If you have vaccines that are within three months of the date of expiration, it is imperative that you notify our office. In many instances we are able to transport vaccines that are about to expire to another location to be used before the expiration date. Depending on the number of doses that will expire, we may also recommend you use as much as you can and expire remaining doses. However, we will make every attempt to transfer the vaccines to another location for administration before the expiration date.

Expired vaccine that is not reported to the VFC Program at least three months prior to the date of expiration may require replacement at your expense. In some cases, replacement of vaccine may be required. Fill out the Wastage portion of the Comprehensive Data Report and send a copy to our office. When we receive this form, we will credit your inventory for the expired doses.

What should I do if there is a discrepancy between my invoice and what is actually in the shipment?

You should always check the quantity, lot number, and expiration date of the vaccines in your shipping container against your invoice to ensure you have received the correct vaccine quantities. In the event you find a discrepancy, double check your shipping container. The foam padding included in the container can hide some of the smaller vials. If you have double-checked the shipper and there is still a discrepancy, please call our office at 1-800-848-3868, and we will contact McKesson to have the problem resolved and the vaccines reshipped.

Administration Fee & Reimbursement

How much can we charge for an administration fee?

You are not required to charge any amount for an administration fee, but you may charge up to $14.81 per injection. You may also charge on a sliding scale.

What is the reimbursement amount for vaccines administered to children enrolled in Medicaid?

The Medicaid reimbursement rate for vaccine administration is $8.00 for a single antigen vaccine and $10.00 for a multiple antigen vaccine.

Who pays the administration fee for children who are underinsured or uninsured?

The parent or guardian would pay the administration fee at the time of service if their child is underinsured or uninsured. However, no child should be denied VFC vaccine due to the parent's inability to pay the administration fee. If a child is enrolled in Medicaid the administration fee is reimbursed after your claim is filed.