What is Partner Responsibility?

The majority of the time we, VaxCare, are able to take care of the billing on your behalf. These claims referred to as VaxCare Bill claims, are filed automatically for you. We bill and you get paid (administration fees only).

Unfortunately, there are some payers and policies that we can't bill on your behalf. It is in these instances, as well as when patients are uninsured, that we require you, our partners, to handle the billing. This is what we refer to as Partner Responsibility. 

Simply put, it means that you are responsible for billing the payer or patient and responsible for reimbursing us, VaxCare, the cost of the administered dose.

When is there Partner Responsibility?

We don't like ambiguity at VaxCare. It's not helpful to anyone. That's why anytime there is partner responsibility we will tell you by marking the appointment or claim as Partner Bill or Self Pay and providing the eligibility response seen below.

Partner Bill

Partner Bill is for patients VaxCare cannot bill. This generally means that one of the following is true:

  1. The patient's payer or plan is out-of-network with VaxCare 

  2. The patient received a vaccine that is out of age indication or otherwise outside of standard vaccine schedules (e.g. a tetanus shot due to a laceration)

Your practice is responsible for filing Partner Bill claims - vaccine cost and admin fees. Bill these as you normally would, along with the patient encounter. Your practice will be charged for the vaccines given to these patients.

Self Pay

Self Pay is for uninsured patients, or those for whom immunizations are not covered. VaxCare does not collect directly from patients on Self Pay. They are treated similarly to Partner Bill. That is, your practice is responsible for collecting from the patient. Your practice will be charged for the vaccines given to these patients at the agreed-upon Vaccine rate for each product administered. What you charge your patients is up to you - see Setting Self Pay Rates for more information.

There are two primary places to find Partner Bill claims and Self Pay claims.  

  1. You will find Partner Bill and Self Pay claims under the Billing tab on the Partner Billing page. We have included a convenient check box to the left of each claim to help you keep track of when you have taken the appropriate action: either billing the claims yourself or charging the patient as a self-pay transaction.  

  2. Partner Bill and Self Pay claims can also be found on the Transactions page. You can use the filter (at the top-right of the page) to isolate Partner Claims or Self Pay Claims. You can also export the results to Excel. 

Related Content: 

How To: Export Partner Bill Claims to Excel

How To: Mark Partner Responsibility Claims as Filed

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