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We use Vaxcare to bill all our vaccines, however we have been told that Part D will cover RSV, but so far they all are coming back as non covered and require a co-pay. Anyone else having this issue??
We use Vaxcare to bill our vaccines also. We have people with part D showing a $0.00 payment for RSV vaccine just like it does with Shingles. However, if they do not have part D then there is no coverage for the vaccine so it would be self pay only. If you have any additional questions you can call me at the Lawrence co HD 417-466-2201. Ask for April
Are you running the Medicare D? If it says $0 then it is covered. If their part plan doesn’t cover it there will be a co pay amount. Even if it is $0 you still have to put a credit card on file. We just use our health department card for that we have never (knock on wood) been charged if the original eligibility check says $0.
I believe that now under Part D, if you are not a pharmacy, the member would need to pay up front to you and then seek reimbursement through Medicare.
We do not use Vaxcare but we use Transact Rx and we bill Part D through them with no issues. They do not pay us up front. Part D still pays even if you are not a pharmacy.
Does Transact RX bill as the patient/on behalf of the patient? I was under the impression that this was the only way to make that work. Thanks
We also use Transact RX and it shows what amount is covered and what the patient responsibility is. Transact RX bills Medicare Part D on our behalf. It shows the billed amount, the admin fee billed amount, total billed and what is to be collected from the patient. It also shows the total that will be billed to the provider.
Hope this is helpful
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