Vaccinating a patient - and VaxCare's Risk Free Guarantee - both start with checking your patients into our system. The integration between VaxCare and Athena does the work of adding patients to the VaxCare Scheduler for you, meaning now we just need to check patient eligibility before vaccinating.

For our integrated partners, we recommend checking the VaxCare Scheduler first thing in the morning and getting all of your patients to Risk Free before the day begins. Around here, we like to call this process "getting our patients to GREEN!"

After all patient appointments have been scheduled in Athena, open the VaxCare Scheduler. All patients scheduled through Athena will show up automatically under the date and location listed for their appointment.

Choosing a Date and Location on the Scheduler

To begin, choose the correct date and location at the top of the Scheduler.

Once you've selected the correct date and location, the list of patients for that date and location will appear on the screen. You can see that the VaxCare Scheduler automatically sorts patients into two categories: Action Required (red eligibility icons) and Scheduling Complete (green eligibility icons). 

Scheduling Complete: Green Eligibility Icons

Just like the fictional Scheduler above, most of your patients will have a green icon, will move to the Scheduling Complete section automatically, and will require no further action. For example, both Mr. and Mrs. Eligible returned a green check. If you click on their Eligibility Icon, the system shows they are Risk Free, meaning they are ready to be vaccinated! 

A green yield sign generally means that the patient is Eligible, but they have limited vaccine coverage, like a Medicare B patient only being eligible for flu, Pneumovax, and Prevnar. That’s why it’s always important to click on and read each Eligibility response until you are familiar with the responses the system is giving you.

If any patient in the Scheduling Complete section shows a red dollar sign, this means you can vaccinate the patient, but in order for the vaccines to be financially Risk Free for your practice, you must collect the information requested. For non-Medicare patients, the red dollar sign is an indication that your patient has a high deductible plan and vaccine coverage cannot be verified, so the pop-up will prompt you to enter a method of payment in case the patient has some financial responsibility.

Patients with Medicare D

For Medicare D patients, the red dollar sign indicates that the patient has additional vaccines available to the patient through their Part D coverage. 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 icon in the patient responsibility column.

To run a successful Med D eligibility check, you must provide a valid social security number. The patient will almost always have a copay. This copay 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 copays for Medicare vaccines.

Once you enter this payment information, your Med D icon will have a green check mark, ensuring that your patient's check-in is Risk Free.  

If your patient is not eligible or the patient has already received TDAP or Zoster, the vaccines will not show up in the list of covered vaccines and you will see the red Med D icon.

Once you have confirmed Med D eligibility and entered the patient's copay information, click on the printer icon to the left of the patient's name to print their consent form. Have the patient sign the consent form before vaccine administration. 

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.

Once you have administered the patient's vaccine(s), fax the signed consent form (or batch of consent forms) on a daily to weekly basis to 855-418-9149. VaxCare will reply with a confirmed receipt.

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

Action Required: Red Eligibility Responses

For patients in the action required section, where the icons are RED, simply click on the Eligibility Icon and follow the prompts provided in order to get the patient to green. Remember that our Risk Free Guarantee is here to help you, and a Not Eligible response just means that something is wrong with the information provided.

In this case, our patient’s member ID is expired. We’ll simply update the patient’s insurance information in Athena when they arrive. 

This new information will be sent to VaxCare as soon as you select "Update Policy" in Athena. The insurance eligibility will rerun in VaxCare automatically, and the eligibility icon will turn from a red X to a green check. Our patient will move to the Scheduling Complete section, and they’ll be ready to go!

Let's Review

Always check the VaxCare Scheduler before vaccinating. 

Always click on the Eligibility icon if you are unsure what a response means or how you can correct the issue the system has identified.

Always make changes to patient demographic or insurance information in Athena. This information will be automatically sent to VaxCare.

What should you do if the patient you are checking in shows a Red X (“Not Eligible”) under the Eligibility column?


Have a question? Click on the blue Intercom bubble to message our team. Or email us at
help@vaxcare.com. We love to help!

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