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Scotland County health board approves small write-offs after CAQH credentialing error stalled vaccine reimbursements
Summary
Board approved writing off $112.15 and 5¢ after a credentialing error in CAQH caused insurers to withhold payment for vaccine supply costs; staff said the credentialing issue has been corrected and the administration fee was recovered but vaccine costs were not reimbursed for affected claims.
The Scotland County Board of Health unanimously approved a motion to write off small uncollectible charges — recorded in the meeting as $112.15 and 5¢ — after staff described a credentialing error that temporarily prevented insurers from reimbursing the county for vaccine costs.
Health department staff described how insurers reimburse immunizations in two parts: payment for the vaccine itself and an administration fee to cover the nurse's time. "They pay for the actual cost of the vaccine, and then they pay you kind of just like in, like, auto repair," a staff member said. "So the part is the immunization. The labor is the admin fee for the nurse that gives it. So they paid the admin fee ... they don't pay for the part."
Board members asked whether the county could retroactively bill for the unreimbursed vaccine costs. "Are we able to retroactively bill for that?" a board member asked. Staff said the issue appeared tied to CAQH credentialing and that it has been corrected. "It's not an issue anymore because now he's credentialed now. That's not a problem anymore. It's been solved and corrected," a staff member said.
The staff member explained the practical effect: some patients were advised to obtain vaccines elsewhere once the error was identified, and the county lost reimbursement for the vaccine cost on the handful of claims submitted before the credentialing issue was fixed. Staff asked the board to approve writing off the small outstanding amounts; the motion passed by voice vote.
The board asked staff to return next month with a clearer figure of the total unreimbursed costs so members could assess the fiscal impact. After the vote the board moved into a closed session.
