Patient Benefit Information
Welcome to the Merck Vaccine Reimbursement Support Center, sponsored by Merck &
Co., Inc. The Merck Vaccine Reimbursement Support Center (MVRSC) will work with
managed care organizations to provide you with Insurance coverage information
regarding your privately insured patients. Before you submit a request, you will need to know the
patient's private insurance company and telephone number, group name, subscriber
ID, and date of birth.
This site is intended for use by physicians and their staff. It is not for use by patients or consumers.
The Merck Vaccine Reimbursement Support Center (MVRSC) will contact the third-party
private payor you specify in this request to inquire about insurance coverage status
for the product specified. Please complete all applicable fields for the patients.
Your request will not be processed unless Yes is clicked agreeing to the HEALTH
CARE PROVIDER(S) DECLARATION below. This request has been prepared exclusively by
the physician or physician office identified in this request. Merck & Co., Inc.,
has retained Telerx, a supplier of reimbursement support services, to support the
MVRSC. Information and questions related to the information provided in this report
by the MVRSC should be referred directly to Telerx. Merck personnel are not aware
of patient insurance coverage information and are not permitted to discuss such
information with customers.
Before any of your patients' private insurers can be contacted by Telerx to facilitate
your request for coverage information, each patient's permission is needed to authorize
the use and sharing of protected health information about the patient for this purpose.
Telerx may need to provide each patient's name, date of birth, diagnosis, insurance
information, or other information to the insurer. In turn, the insurer may transfer
such information back to Telerx. Telerx will use this information solely for facilitating
and responding to this request; however, the individuals to whom Telerx provides
this information may further release this information without Telerx's knowledge.
By clicking Yes below, you represent and warrant that your practice has obtained
written authorization from each patient to provide the MVRSC with the information
included in this request, and for the purposes described herein, and has provided
all notices necessary to comply with all federal and state laws and regulations
relating in any way to medical and/or health privacy including but not limited to
the HIPAA Privacy Rule, codified at 45 C.F.R. Parts 160 and 164, as amended from
time to time.
Disclaimer: The information that will be provided to you in response
to your request for insurance coverage information will be based on statements of
individuals not affiliated with Telerx or Merck & Co., Inc. Neither Merck &
Co., Inc., nor Telerx make any warranties, expressed or implied, about the accuracy
of this information. Insurance coverage status can change over time based on a variety
of factors, including processing of additional claims that impact deductibles and/or
coverage limits, changes in benefit design and a patient's change in insurance carrier.
Any coverage information provided to you in response to this request is intended
for your reference only and does not guarantee current or future coverage for any
Merck vaccine. The Confidence in Coverage Status program for Merck Vaccines will accept
patient inquiries from March 25, 2013 through December 31, 2013. Individual patient
coverage reports will be provided to the extent that information is made available
by the insurance plan. Patient coverage information will be provided on portal as information is obtained. Merck's goal is to respond to your request in 3 to 5
business days. Merck's ability to respond within this time frame may be affected
by various factors, including the willingness of insurance companies to release
insurance coverage information.