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Medical providers seeking reimbursement for COVID vaccine causing confusion

Providers can seek reimbursement from insurance companies for vaccine administration fees
Published: Apr. 6, 2021 at 10:43 PM EDT
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OREGON, Ohio (WTVG) - Tina Leach was shocked Tuesday when she received her mail.

She and her husband got their first COVID-19 vaccine on March 18 at ProMedica Bay Park Hospital.

Nearly three weeks later, she opened an envelope to find a letter with his name on it and a listed account balance of $68.

“This is just ridiculous and I’m so upset about it,” Leach said.

The letter says there is no account on file with his name and asks him to fill out his insurance information.

She called the customer service number at the bottom of the letter.

“When I asked her on the phone, they said, ‘We need his information so we can submit it to his insurance.’ I said, ‘No. I’m not giving you his information.’”

She has not received a similar letter.

The CDC says COVID-19 vaccination providers can’t charge you for the vaccine itself. They can’t charge you directly for any administration fees, copays, or coinsurance. Plus, they can’t charge an office visit fee if the only reason someone visited was to get vaccinated.

But providers can seek reimbursement from private health insurance, Medicare or Medicaid for a vaccine administration fee.

Leach said that wasn’t made clear to her and her husband when they got vaccinated. It’s also not explained in her letter.

“We went there, showed them our ID, filled out paperwork, and that’s it,” Leach said. “They didn’t ask us for any insurance information. If they would’ve said, ‘We need your insurance’ or something, I would’ve understood. But that wasn’t the case.”

A ProMedica spokesperson says it does not charge for the COVID-19 vaccine, but a normal vaccine administration fee is covered by insurance providers, Medicare and Medicaid.

ProMedica waives that fee for people without health insurance coverage and says nobody will be directly responsible for charges associated with getting a COVID-19 vaccine.

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