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Because of where they are administered, vaccines and their administration are not a great fit with a prescription drug benefit program. Part D is essentially an outpatient drug benefit based upon network pharmacies, providing access to Part D plans’ negotiated prices. And a vaccine is often administered in a physician’s or other provider’s office and has been typically treated as a medical benefit for billing and reimbursement purposes. With CMS requiring formulary coverage of non-Part B vaccines and reimbursement of vaccine administration fees as of Jan. 1, 2008, and as new vaccines come on the market with indications for use by Medicare beneficiaries, in-network access for Part D vaccines has become imperative. This new CMS vaccine requirement has led to numerous billing problems for Part D sponsors, since coverage and administration of vaccines must be handled by the Part D sponsor. But most physician practice management systems do not accommodate Part D billing, forcing beneficiaries to pay out-of-pocket for their vaccines and then submit paper claims to plans for reimbursement. Moreover, billing the Part D vaccine administration fee through the pharmacy claims system may not involve use of a single code, but instead may require system users to input information into different fields on the electronic pharmacy claim. Different Part D plans may require different inputs in order to appropriately bill and reimburse the fee. Join us on Sept. 25 and hear valuable intelligence about CMS’s new vaccine coverage and administration billing requirements and options, plus strategies for billing vaccine administration fees. Learn how to cover and bill for vaccines correctly to avoid CMS sanctions and enforcement action. Topics to be covered include:
Team-Wide Training at Its Best (and most cost- and time-efficient). Gather your management team around the table on September 25 for one low single-participant price. And photocopy for each of them as many copies of our printed materials as you need. Managers throughout your organization will find out how to bill correctly for vaccines and avoid becoming an enforcement target.
Andrea Serrate, CPA, is vice president of specialty and payer services for Poc Network Technologies, Inc (PNT) as well as managing partner for Specialty Services of America, LLC, a national health care consulting firm located in Phoenix, Arizona. While contracting with PNT’s partner, Dispensing Solutions Inc., Serrate was responsible for identifying and developing the business model for the eDispense Vaccine Manager. She previously held senior management positions with national health care organizations, including NovaCare and BMJ Medical Management, Inc. Moderator: Barbra Golub, JD, managing editor of Medicare Part D Compliance News.
Compliance officers, pharmacy directors, financial managers, legal counsel and physician leaders at:
1. Register above (or call 800-521-4323 to register). 2. When you register, you will receive a confirmation by e-mail from AISconferences@aispub.com, with a toll-free number and password that will connect you to the Audioconference on Thursday, September 25, 2008 (1 p.m. Eastern time). There is no limit on the number of participants from your office, but the registration fee covers only one phone dial-in. Additional dial-ins require additional registration fees. For discount pricing on additional phone lines, please contact customer service at 800-521-4323. 3. You will also receive copies of the Printed Materials (in PDF format by e-mail). 4. Listen in to the Audioconference as you follow along with your Printed Materials. 5. The final segment of the Audioconference will let you ask questions and get answers about how to bill correctly for vaccines and avoid becoming an enforcement target. 6. Cancellation Policy: To cancel your registration for this event and receive a full refund, you must contact customer service at 800-521-4323 no later than 48 hours prior to the scheduled start of the audioconference. Any cancellations received after dial in information and supplemental materials have been sent (48 hours prior to the start of the audioconference) will receive a CD of the audioconference or a credit valid for one year. Your credit (the cost of the audioconference) will be applied toward the purchase of any AIS product or audioconference. Can't make it on September 25? Order the CD or MP3 file and Printed Materials. Remember: A copyright release in the Printed Materials will permit you to make photocopies for each person listening to the Audioconference and/or recording.
Please note that CDs and MP3 files will be available within three weeks of the conference date. Audio CDs (and accompanying written materials) are shipped via UPS. Please give us your street address when you order (UPS does not deliver to PO boxes). You should receive your order within 5-7 business days.* Shipping cost is $5. MP3 files will be delivered as a download link within a PDF file of the accompanying written materials. Shipping will NOT be charged for this item.
Rush Orders: Please call us at 800-521-4323 to place a rush order.* We will overnight your order for an additional charge of $30, or you can give us your FedEx or UPS account number and we will charge the shipping to your account. Rush orders placed after 3:00pm EST will not be shipped out until the next business day. *CDs and MP3 files will be available within three weeks of the conference date.
Listeners will also receive practical written information to supplement information covered by the audioconference speakers.
For further information call 800-521-4323 or e-mail customerserv@aispub.com |
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1100 17th Street, NW, Suite 300, Washington, DC 20036
Phone 202-775-9008 or 800-521-4323; E-mail customerserv@aispub.com