Most of your patients will go through VaxCare's system as "Insurance Pay," meaning VaxCare will bill the patient's insurance to cover the cost of their vaccines and pay your office for administering them. This is certainly the preferred method of payment with VaxCare, because it's the only payment method eligible for our Risk Free Guarantee!
However, we know that we don't live in a perfect world, and sometimes your patient has an out-of-network plan or needs to pay cash for their vaccines. VaxCare created our system to work for your office, so we offer alternate methods of payment for these patients. A description of each method of payment is below.
Insurance Pay: This is the default method of payment on patient check-in and means that VaxCare will bill for both the CPT on the vaccine and the CPT on the administration of that vaccine. This also means, by nature, that your office does not bill for any portion of the patient's vaccines. It is important that you follow our billing policies to prevent double-billing of the patient's insurance policy. For more information, see VaxCare Billing Policies.
Partner Bill: Partner Bill means that you, as our partner, have elected to bill for your patient's vaccine(s) for this encounter. When you Partner Bill, your office will bill for both the CPT on the vaccine and the CPT on the administration, then VaxCare will deduct the base cost of that vaccine from your next compensation check.
Generally, there are 3 reasons why we would recommend you use this payment option: 1) The patient has an insurance plan that is not currently contractee with VaxCare, 2) The patient is knowingly receiving a vaccine out of age indication, or 3) The patient is receiving a vaccine because of a medical condition that would otherwise not be covered by the insurance company (i.e. a second tetanus vaccine in a 10-year-window due to a laceration).
Self Pay: This payment option is used when a patient does not have insurance coverage for their vaccines and/or they do not wish to give you their insurance information. Your practice will set office-specific Self Pay rates, and the patient will pay your practice directly, at the time of service, for their vaccines. You do not need to report your self-pay rates to VaxCare, but we do recommend charging enough to at very least cover the cost of the vaccine. For more information, see Setting Self Pay Rates.
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