In May 2010, funding for state-supplied vaccines for privately insured children was scheduled to end. Through the WVA's work as an independent, nonprofit organization, the state has been able to continue universal purchase of state-supplied vaccines for all children under the age of 19.
What This Means for Providers
How State-Supplied Vaccines Are Funded
- You can continue to receive vaccines at no charge from the Washington State Department of Health – and give your patients easy access to critical vaccinations.
- You avoid the financial and staffing burden required to purchase vaccines on your own.
- You don’t need to store vaccines separately for privately and federally covered children.
Health plans, insurers, and other payers now pay for administered vaccines based on a per dosage assessment. The WVA collects these payments and transfers the funds to the state.
Through its Childhood Vaccine Program, the state Department of Health buys the vaccines at federal contract rates and distributes them to physicians, clinics, hospitals, and other providers at no charge.
What You Should Do
Because payers now cover state-supplied vaccines for privately insured children, there are new requirements for processing administered vaccines.
Dosage-Based Assessment (DBA) Process
Please reference the Assessment Guide for electronic and paper claim submission.
- Submit the usual HCFA 1500 form for the administration of the vaccine, office visit, and other charges, just as you always have, but without the vaccine codes and modifiers.
- Submit a second HCFA 1500 form that contains the vaccine codes and the dosage-based assessment charges, which you’ll find on the Final Assessment Grid
- Submit both forms to the appropriate health plan, insurance company, or TPA, not to the WVA.
Providers who have not yet changed to the two-form DBA process should contact the WVA for help (888-928-2224).
What is the Washington Vaccine Association?
Washington Vaccine Association (mp4)
How to File HCFA 1500 Forms
HCFA 1500 Forms (mp4)
How to File an Electronic Form
File Electronic Forms (mp4)
WVA Dosage-Based Assessment Webinar Held Feburary 23, 2016
DBA Training Webinar (mp4)