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Frequently Asked Questions


The Washington Vaccine Association enables the state to continue universal purchase of childhood vaccines. The WVA collects funds from health insurers and remits them to the state to cover the cost of vaccines for privately insured children. As a result, Washington is able to purchase vaccines for all children at volume rates and deliver them to providers at no cost.

The FAQs are divided into five categories:

  1. "A" means questions related to Assessment Payers (Including TPAs & Insurers).
  2. "D" means questions related to Dosage-Based Assessment Billing.
  3. "G" means questions related to Government Programs.
  4. "P" means questions related to Providers.
  5. "V" means questions related to Vaccines.

ASSESSMENT PAYERS (Including TPAs & Insurers)
Show details for A1. What are the benefits of participating in the program for payers?A1. What are the benefits of participating in the program for payers?
Show details for A2. Do out-of-state payers know about the DBA billing process?A2. Do out-of-state payers know about the DBA billing process?
Show details for A3. Whose responsibility is it to make sure the DBA information reaches the payer and that payment reaches theA3. Whose responsibility is it to make sure the DBA information reaches the payer and that payment reaches the WVA?
Show details for A4. Who needs to register as a TPA and how often do I need to register? A4. Who needs to register as a TPA and how often do I need to register?
Show details for A5. How will I know that my registration was received correctly in the system and is now effective? A5. How will I know that my registration was received correctly in the system and is now effective?
Show details for A6. Does the WVA resell vaccines?A6. Does the WVA resell vaccines?
Show details for A7. How can I tell if my TPA information is current in WVA's system and how do I edit my record?A7. How can I tell if my TPA information is current in WVA's system and how do I edit my record?


DOSAGE-BASED ASSESSMENT BILLING
Show details for D1. How does my office need to bill to ensure that payers are responsible for the cost of state supplied vacciD1. How does my office need to bill to ensure that payers are responsible for the cost of state supplied vaccines that we provide to children with private insurance?
Show details for D2. Where do I put the NPI number on the DBA when submitted on a Form 1500?D2. Where do I put the NPI number on the DBA when submitted on a Form 1500?
Show details for D3. How do we fill in Box 31, “Signature of Physician or Supplier?”  D3. How do we fill in Box 31, “Signature of Physician or Supplier?”
Show details for D4. How does the DBA process work with the electronic form? D4. How does the DBA process work with the electronic form?
Show details for D5. Do you have sample forms I can look at?D5. Do you have sample forms I can look at?
Show details for D6. Whose responsibility is it to make sure the DBA information reaches the payer and that payment reaches theD6. Whose responsibility is it to make sure the DBA information reaches the payer and that payment reaches the WVA?
Show details for D7. Do I use the DBA process for billing when a patient has primary insurance from a private insurer and seconD7. Do I use the DBA process for billing when a patient has primary insurance from a private insurer and secondary insurance from the state?
Show details for D8. If a payer denies our administration charges and we are resubmitting the claim, do we bill the payer againD8. If a payer denies our administration charges and we are resubmitting the claim, do we bill the payer again for the WVA?
Show details for D9. We bill through a clearinghouse. What if a claim scrubber rejects our submissions because we used your fedD9. We bill through a clearinghouse. What if a claim scrubber rejects our submissions because we used your federal tax ID and NPI numbers?
Show details for D10. How did you come up with the dosage-based assessment (DBA) methodology?D10. How did you come up with the dosage-based assessment (DBA) methodology?
Show details for D11. How often will the WVA update its assessment grid?D11. How often will the WVA update its assessment grid?


GOVERNMENT PROGRAMS
Hide details for G1. Has the WVA changed anything for the federally funded Vaccines for Children (VFC)? G1. Has the WVA changed anything for the federally funded Vaccines for Children (VFC)?
No. Neither the federally funded Vaccines for Children Program entitlement, nor the state’s purchase of vaccines for children in state-sponsored medical plans are affected by the WVA.

Show details for G2. How does this affect Medicaid and Medicaid managed-care plans? G2. How does this affect Medicaid and Medicaid managed-care plans?
Show details for G3. How are the vaccines reported for patients who don't have insurance? G3. How are the vaccines reported for patients who don't have insurance?


PROVIDERS
Show details for P1. What are the benefits of participating in the program?P1. What are the benefits of participating in the program?
Show details for P2. Do providers need to continue filling out the vaccine reports for Public Health, in addition to completingP2. Do providers need to continue filling out the vaccine reports for Public Health, in addition to completing the DBA?
Show details for P3. Do providers need to put vaccines for privately insured children in a different refrigerator from federallP3. Do providers need to put vaccines for privately insured children in a different refrigerator from federally funded vaccines?
Show details for P4. Do providers need to screen for VFC eligibility? P4. Do providers need to screen for VFC eligibility?
Show details for P5. Do we still need to report vaccine usage by age group, or will the WVA gather that data? P5. Do we still need to report vaccine usage by age group, or will the WVA gather that data?
Show details for P6. What kind of auditing process can we expect? P6. What kind of auditing process can we expect?
Show details for P7. Will providers receive notification when WVA receives assessments from insurers? P7. Will providers receive notification when WVA receives assessments from insurers?
Show details for P8. What actions should Washington providers take when administering vaccines to children who are Idaho resideP8. What actions should Washington providers take when administering vaccines to children who are Idaho residents?
Show details for P9. Do providers have a choice of vaccine brands?P9. Do providers have a choice of vaccine brands?
Show details for P10. Are the requirements for providers compliant with HIPAA requirements? P10. Are the requirements for providers compliant with HIPAA requirements?
Show details for P11. Don’t we have to have an agreement with you in accordance with HIPAA laws, since you receive patient infP11. Don’t we have to have an agreement with you in accordance with HIPAA laws, since you receive patient information?
Show details for P12. Can patients who want to keep their vaccinations confidential (e.g., for HPV) opt out of having the insurP12. Can patients who want to keep their vaccinations confidential (e.g., for HPV) opt out of having the insurer billed so their parents don’t find out?


VACCINES
Show details for V1. What about childhood vaccines that aren’t listed on the WVA Assessment Grid? V1. What about childhood vaccines that aren’t listed on the WVA Assessment Grid?
Show details for V2. How are vaccines added to the Assessment Grid?V2. How are vaccines added to the Assessment Grid?


FAQs PDF








WVA Tax ID: 27-2251833 | WVA NPI: 1699092718


Copyright 2013 Washington Vaccine Association