Please be advised that for both safety and insurance coverage purposes, we cannot bill for vaccines given outside of manufacturer age indications. That said, if you are needing to intentionally vaccinate a patient out of age indication due to a clinical need for vaccination, we have a solution for you!
Anytime you plan to give a vaccine out of age indication, the dose will immediately default to Partner Bill post shot, so that we can allow your practice to bill for those vaccines directly. The insurance company will deny the claim unless clinical justification is provided, and we simply don't have the details of why you are vaccinating a patient outside of manufacturer recommendations. But you do! That's why you're vaccinating them, after all.
Please do not send faxes or emails describing the patient's diagnoses, disabilities, or any other sensitive information regarding why you vaccinated a patient out of age indication. Simply notify Customer Care of the situation, file the claim with the insurance company and provide this clinical information directly to the insurance company when requested. We do not need to know - or want to know - that your patient has HIV, COPD, or any other condition.
Our VaxHub will make age indication recommendations based on ACIP and manufacturer guidelines, but it will also let you override the safety warning if you wish to vaccinate your patient out of age guidelines. This serves as your reminder to Partner Bill for these patients/vaccines.
Still have questions? Reach out to our Customer Care team. We're happy to help! Message us directly by clicking on the blue Intercom bubble in the bottom right corner of your screen. Email us at firstname.lastname@example.org. Or call us at 1-888-829-8550.