From the Quick Tools link, select Pharmacy Tools, then Medicare Formularies. Providers who do not have access to a vaccine on the formulary can call the prescription into a participating pharmacy. If the vaccine is administered in a network pharmacy, the pharmacy will transmit the claim to the Pharmacy Benefit Manager for processing and reimbursement.

Providers who have a supply and administer the vaccine in their office should collect the member’s copay at time of service and submit the claim for the vaccine and administration on a CMS 1500 (08-05) form to:

Amerigroup
Attn: Claims Department
P.O. Box 61010
Virginia Beach, VA 23466-1010

To streamline your claim processing and payment (as applicable) for these and other preventive vaccines covered under Part D, providers may use TransactRX, a clearinghouse for claims submission for Part D coverage. To use TransactRX please contact the clearinghouse at the web site (http://www.transactrx.com) or call Customer Service at 1-866-522-3386. Physicians, facilities, health clinics and pharmacies may use this clearinghouse to process Part D claims. There is no charge to providers who use electronic funds deposit to receive payment. There is a service fee of $2.50 for check payments on claims.

For member copayment information, please call Amerigroup at 1-866-805-4589.