It is the provider's responsibility to complete the DBA process accurately to avoid denials and to resubmit or respond to payer requests to the same
Do I use the DBA process for billing when a patient has primary insurance from a private insurer and secondary insurance from the state?
If you normally bill the state insurance plan or the Health Care Authority (HCA) for the vaccine, continue to do so. If you normally bill the private
If a payer denies our administration charges, do we submit the DBA again?
In situations where you would rebill for yourself you would also resubmit the DBA for the WVA. For example, if your administration claim is denied for
Is there a cap on the vaccine administration charge we can bill to the payer?
The DOH administration fee cap is found on Page 8, #6 of the DOH Provider Agreement: Enrollment Packet. This applies a $23.44 cap to all
We bill through a clearinghouse. What if our submissions are rejected because we used your federal tax ID and NPI numbers?
Please advise your clearinghouse that you’ll be using the DBA process, with our name, Tax ID, and NPI. Our Billing Guide has specific information for
How did you come up with the dosage-based assessment (DBA) methodology?
In the months leading up to the formation of the WVA by the state legislature, a multidisciplinary group of stakeholders evaluated a number of
Do you have sample forms I can look at?
DBA Form Sample (pdf) Completed samples of the two forms required for the dosage-based assessment (DBA) process. Electronic Form