DocStation, a medical billing infrastructure platform for retail and community pharmacies, announced a strategic partnership with Vaccine Connect to help member pharmacies capture higher vaccine revenue through comprehensive medical benefit billing.
The partnership addresses a significant revenue gap in independent pharmacy. While pharmacies typically bill vaccines through pharmacy benefit managers (PBMs) at $15-20 per dose, medical benefit reimbursement for the same vaccines averages $50-65 per dose—a 132% increase that most pharmacies are currently missing.
According to DocStation data, pharmacies can capture $40+ additional revenue per vaccine compared to PBM billing, with 132% higher reimbursement rates through medical benefits vs. pharmacy benefits. The platform includes automatic Medicare Advantage coverage detection to eliminate billing errors.
DocStation's platform enables pharmacies to bill vaccines across the full medical benefit landscape, including commercial insurance, Medicare Advantage, Medicaid, and Medicare Part B. Features include Pass Back Eligibility Verification with real-time medical benefit verification, AI Copilot for Revenue Cycle Management analyzing rejected claims, Real-Time Medical Claim Creation with validation and preview, and Universal Payer Compatibility for billing any insurance.
"A pharmacy administering 1,000 flu shots captures an additional $40,000 in revenue by routing to the medical benefit instead of PBMs. We're talking about transformational margin expansion," said Samm Anderegg, CEO of DocStation.
"Better buying plus better billing – that's the complete equation for vaccine program profitability," said Amanda Pritchett, MHA, Director of Vaccine Connect.
The partnership supports comprehensive vaccine billing across all immunization types, including flu, COVID-19, pneumococcal, shingles, RSV, travel vaccines, and pediatric schedules.
The partnership launches with webinar sessions in December 2025, led by Rachael Matz, DocStation's Head of Clinical Solutions, covering vaccine medical billing fundamentals and implementation strategies.