Once you are in the Schedule for the day, Medicare D patients will present with  Med D - Eligibility Check Undetermined. This indicates that the patient is age appropriate to initiate the eligibility process. Before we jump into the functionality of the portal, here are a few important items to remember.

  1. Run the check- Med D eligibility DOES NOT run automatically. You must click on the run Med D eligibility in the appointment page. 

  2. Input Social Security # & Credit Card-  you will need the patients Social Security number in order to run the eligibility check.  If not present, they system will prompt you to record the SS # in the patient information page. Most patients will have a co-pay which will require that you taken a credit card to process payment (card will be processed with in 48 hours)

  3. Print + Sign + Return Consent Form- click on the print consent form from the appointment page.  You must upload to VaxCare a signed copy of the patient consent (for more information see Print + Sign Consent Form below).

OK, now let's take a quick look at the Medicare D process.

If you have a patient who is 64 or older, VaxCare will present a “Med D – Eligibility Check Undetermined” message.

Once you have clicked on the patient in the Patient Schedule it will take you to the appointment page. Prior to running the Med D eligibility check, you must provide a valid social security number. This is recorded in the patient information page. Once recorded the SS # you can proceed and click "Run Med D Eligibility".

The patient will generally have a co-pay. This co-pay must be collected by entering a credit or debit card, which will be charged within 48 hours from administration of the patient's vaccine(s). We cannot accept cash co-pays for Medicare vaccines. See below for an example.

The Patient Schedule grid (on the date of service) and the Clean-Up view (for up to 7 days after date of service) will provide you with updates as to what information is needed.

As you collect the needed information, any missing information will be displayed as a secondary message (below) stating what is needed. 

  • MED D- Eligibility Check not Run (can only be run on the day of service)

  • MED D- Consent form needed (see Print + Sign Consent Form below) 

  • MED D - Credit Card Not Provided

Once all the information has been collected you will see the following message for the Med D portion of the claim. 

  • Eligible-Credit Card and Consent Form provided

Once you have confirmed Med D eligibility and entered the patient's copay information, click on the print consent form from the appointment page to print their consent form. Have the patient sign the consent form before vaccine administration.

Lastly, upload the signed consent form (or batch of consent forms) on a daily to weekly basis. Simply have the patient sign the consent form, scan it into your computer, and securely upload these forms right from your Vaxcare portal by clicking Resources (up top) -> Forms (left hand panel) -> Consent Form Uploader. 

Uploading through our portal ensures secure and HIPAA compliant transmission of protected health information (PHI).  We use ShareFile to upload, a third-party HIPAA Compliant solution.  

Log into your portal and click HERE to be directed to our consent form upload page. 

VaxCare will not submit the Med D claim to Medicare until after the signed consent form has been sent to us. If we do not receive the signed consent form after 25 days, VaxCare will charge back to you, as the partner, the cost of the Med D vaccine.

Why is a Signature Required?

It is a CMS requirement to capture patient signature. CMS (Centers for Medicare and Medicaid Services) requires signature of the patient or the patient’s legal representative to validate a properly executed Medicare D informed consent. 

Therefore, VaxCare requires a copy of the signed patient consent for Med D.

If VaxCare does not receive the signed consent form after 25 days, VaxCare will charge back to you the cost of the Med D vaccine.

Additional Notes

My Patient does not have Med D- If the patient has Medicare Part B (or an Advantage Plan) and only wishes to receive flu, Pneumovax, or Prevnar, you do not need to complete the Medicare D workflow or enter a credit or debit card. If the patient only has Medicare Part B and does not have Medicare Part D, they need to self-pay for TDAP or Zoster, as they do not have insurance coverage that will cover the cost of these vaccines.

No credit card provided-  In the event a credit card was not collected for a Med D eligible patient who receives a vaccine under Med D, VaxCare will send a statement to the patient and attempt to collect the monies due. If VaxCare is unable to collect from the patient, we will charge the practice for the dose.

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