COVID Vaccine, Therapeutics & OTC Test 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 and therapeutics.
Name of Submitting Person
Please enter a valid phone number.
Name of payer for the issue in this report (PBM, insurance company)
Medicare Part B
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 product is involved with this claim?
Janssen (J&J) Vaccine
OTC COVID Test
Which dose was this claim for? (For OTC Test, select Other, specify which test)
First of two doses
Second of two doses
Third mRNA dose (immunocompromised patient)
Booster mRNA dose
Monoclonal Antibodies initial or repeat
Antiviral Course of Therapy
What issue(s) did you have with billing this claim with this payer? (check all that apply)
PBM paid an unexpected amount
Claim shows a non-zero patient copayment
Patient not eligible
Told to bill the claim elsewhere
Told that the patient needs to go elsewhere to get vaccine, monoclonal antibodies or antiviral
Issue with correct recognition of first/second/third/booster dose
Not in-network for OTC Test billing
OTC Test non-preferred NDC, use a different product
Please briefly describe the prescriber issue.
Please provide any other information you feel is relevant to this issue (Do NOT included any PHI).
Should be Empty: