Description of Services
The Merck Vaccine Reimbursement Support Center™ (MVRSC) can help to answer the following types of product reimbursement questions common among physicians and their staffs:
- What is the appropriate CPT®a code to use when I submit claims for reimbursement?
- What should I do if a health plan denies or underpays my reimbursement claim?
- I'm not sure if my patient's health plan will reimburse for a Merck vaccine. How can I find out?
- My patient's health plan requires a prior authorization to administer a Merck vaccine. What is the process for submitting it?
- How does Medicare Part D apply to Merck's adult vaccines?
- Are Merck's adult vaccines reimbursed under Medicare Part D? How are claims submitted for vaccines reimbursed by Medicare Part D?
- How can I find out if an insurance company is reimbursing for a Merck vaccine?
Major Categories of Services
Services provided by the MVRSC include:
- Coding. The MVRSC can provide you with certain coding information for the Merck vaccine and the administration of the vaccine.
- Claim denial. The MVRSC can help you to determine reasons for insufficient reimbursement and/or denied claims from a particular insurance company, and provide sample letters if re-submittal is appropriate.
- Insurance Verifications. The MVRSC can assist you with insurance verification (up to five (5) verifications per month, for each office location within the same health care practice), and prior authorization processes.
- Prior Authorization. The MVRSC can assist you with the insurance verification and prior authorization processes. Please note that insurance verification requests are limited to five (5) verifications per month for each office location within the same health care practice.
- Medicare Part D. Explain which Merck adult vaccines may be covered under Medicare Part D, and how the claims process works.
In addition, the MVRSC can provide general reimbursement information that it has on file.
The MVRSC professional staff will provide personalized assistance for appropriate billing, coding, or other claims submission procedures related to Merck vaccines.
The Reimbursement Specialists are accustomed to working with all management levels regarding claims, case management, provider relations, and benefit plan issues related to insurance reimbursement matters, across all major health insurers.
Specific reimbursement rate information may be obtained by contacting the payer's provider relations department or representative. To access rate information, the provider may require your National Provider Identifier (NPI) or Tax Identification Number and/or provider number.
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