- Payers should reverse and adjust the payments.
- Payers should review their systems to ensure the correct set up to avoid such errors.
Key requirements outlined in the WVA Health Insurers & TPAs Compliance Guide include:
- The full WVA Vaccine Assessment Grid amount is due to the WVA.
- There is no patient responsibility.
- There is no timely filing limitation for DBAs where they are a statutorily created assessment.
- There are no out-of-network (OON) denials.
- Working collaboratively with the WVA to resolve any denial or payment issues.
- Electronic Remittance Advices and ACH Payments are preferred.
- TPAs are required to register and maintain contact information on the WVA website.