COVID Vaccine Billing Issue Report
Submitters should not expect their individual issues to be resolved from submitting them here. Submissions will be used to identify broad systemic issues with the billing of COVID vaccines.
Name of Submitting Person
Please enter a valid phone number.
Name of payer for the issue in this report (PBM, insurance company)
Name of intermediary used to bill medical benefit
Electronic Billing Services (EBS)
What PBM was the claim submitted to?
Claim submission details
Is your pharmacy IN or OUT of network for this payer?
Out of Network
Which vaccine is involved with this claim?
Which dose was this claim for?
First of two doses
Second of two doses
What issue(s) did you have with billing this claim with this payer? (check all that apply)
Administration fee well below Medicare rates
PBM paid an unexpected amount (e.g. $0.01)
Claim shows a non-zero patient copayment
Missing/Invalid prescriber ID when using Pharmacist NPI
Other prescriber issue
Patient not eligible
Told that the patient needs to go elsewhere
Issue with correct recognition of first/second dose
Was incorrectly rejected as a duplicate claim
Please briefly describe the prescriber issue.
Please provide any other information you feel is relevant to this issue (Do NOT included any PHI or payment rates).
Should be Empty: