Merck Vaccine Reimbursement Support Center

Merck Vaccine Reimbursement Support Center

Welcome to the Merck Vaccine Reimbursement Support Center™ sponsored by Merck Vaccine Division of Merck & Co., Inc. This service is intended to provide physicians with possible solutions to the following types of inquiries:

  • What is the appropriate CPT code to use when I submit claims for reimbursement?

  • What should I do if a health plan denies or underpays my reimbursement claim?

  • I’m not sure if my patient’s health plan will reimburse for a Merck vaccine. How can I find out?

  • My patient’s health plan requires a prior authorization to administer a Merck vaccine. What is the process for submitting it?

  • How does Medicare Part D apply to Merck's adult vaccines?

  • Are Merck’s adult vaccines reimbursed under Medicare Part D? How are claims submitted for vaccines reimbursed by Medicare Part D?

  • How can I find out if an insurance company is reimbursing for a Merck vaccine?

Here is How the MVRSC May Be Able To Help You
Reimbursement Issue MVRSC Service
General coding or reimbursement questions The MVRSC can provide general information about coding and billing processes for private sector health plans and Medicare.
Denied or underpaid claim Complete a Request for Benefit Information form, located in the Letters and Forms section of this website, or call 1‑800-734-6282 to request a form. Return the form with the patient’s Explanation of Benefits (EOB). A specialist will research the denied/underpaid claim for you or provide you with suggestions for resubmitting.
Unsure if your patient’s plan will reimburse for a vaccine Complete a Request for Benefit Information form, located in the Letters and Forms section of this website, or call 1‑800-734-6282 to request a form. A specialist will attempt to contact the payer to determine if the patient’s insurance will cover the vaccine.
Prior authorization is required Complete a Request for Benefit Information form, located in the Letters and Forms section of this website, or call 1‑800-734-6282 to request a form. A specialist will work with your office and the payer throughout the process of obtaining an authorization.
Unsure of how the Medicare Part D vaccine claim submittal process works, or which Merck adult vaccines may be reimbursed under Part D Click on the Medicare Part D tab located in this website or call 1-800‑734-6282 to speak with an MVRSC specialist.
Unsure if a payer has implemented reimbursement for a vaccine The MVRSC may have general coverage information on file that can be provided to you.

MVRSC Phone: 1-800-REIMBVAX (1-800-734-6282)

Hours of operation: Monday through Friday, 9:00 am to 8:00 pm ET

20652536(1)- 11/06