CMA urges state to push payors to proactively prepare for pediatric COVID-19 vaccine admin claims

October 26, 2021

The California Medical Association (CMA) this week sent letters to the California Department of Health Care (DMHC) and the California Department of Insurance (CDI) urging agencies to encourage payers to proactively prepare their claims processing systems to correctly process the COVID-19 vaccine application claims from day one for newly eligible populations, especially for the expected approval of the 5-11 year old pediatric vaccine.

To date, some payers have been slow to update their systems to properly process vaccine administration claims, leading to claims denials and denying physicians reimbursement for services rendered to newly eligible patients. While the issues were eventually identified and corrected, the lack of preparedness creates administrative and financial barriers for the physician community to administer COVID-19 vaccines. Addressing these barriers is critical to getting more people vaccinated.

View the letter from CMA here.


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