Getting paid for travel vaccines???

We have medicare pateints with their Part D prescription coverage with Caremark.

The vaccine is being denied as a pharmacy denial. Tufts Medicare Preferred is telling the patients we are billing this wrong? Because we are not a pharmacy.

I am trying to get paid for the typhoid vaccine (90691) for example. This is billed with an office visit (99401) which has been paid. The admin code we are using is 90471.

Any suggestions?

Elaine Frohlich

re: Getting paid for travel vaccines???

It is a pharmacy benefit, Medicare B only pays Flu, pneumovax, and Hep B. You can enroll at enroll.edispense.com and set up to get paid for travel vaccines if their plan covers them (which is doubtful).
Once you are set up, you out in demographics and if their D plan is part of the system then you can see a list of covered vaccines and see the reimbursement. We use it for Zostavax; never tried travel vaccines

re: Getting paid for travel vaccines???

I do billing for a travel clinic too. We do not bill any insurance, even if a Medicare patient comes in. We inform the patient before the appointment that our clinic is not affilliated with any insurance carriers. We do supply the patient with a receipt that includes our clinics tax ID number and the amount of each vaccine. In some cases we will also supply the CPT® and ICD9 codes. We hove found that it is rare to get any kind of payment for vaccines, and the payment we do get, does not pay us any where near what we paid for the vaccine.