• Claims Reimbursement to Health Care Providers and Facilities for Testing and Treatment of the Uninsured During COVID-19

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    COVID-19 Uninsured Program Portal Now Open

    On April 27, HHS, through the Health Resources & Services Administration (HRSA), launched the COVID-19 Uninsured Program Portal to allow family physicians and clinicians who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020, to submit claims for reimbursement. HRSA has contracted with UnitedHealth Group to be the sole administrator of the program.

    How it Works

    Family physicians and clinicians who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020, can request claims reimbursement through the program electronically and will be reimbursed generally at Medicare rates, subject to available funding.

    What do I have to do?

    1. Enroll as a provider participant (open now):

    • Validate Tax Identification Number (TIN validation can take up to two business days to process)
    • Set-up Optum Pay Automated Clearing House (this can take 7-10 business days to process; direct deposit / ACH via Optum Pay is required for reimbursement)
    • Add Provider Roster (this step will be available soon after TIN validation is complete and can take up to three business days to process)

    2. Check patient eligibility (confirm that your practice has checked for health care coverage and the patient is uninsured)

    3. Submit patient information (opens on May 6; patient roster will include demographic information, date of service, etc.)

    4. Submit claims (individually or in batch; opens on May 6)

    5. Receive payment via direct deposit in mid-May

    Get Reimbursed for Unisured COVID-19 Patients

    The COVID-19 Uninsured Program Portal is now open. Request claims reimbursement for treatment provided to uninsured COVID-19 individuals on or after February, 4, 2020.


    What’s covered for my uninsured patients?

    Reimbursement will be made for qualifying testing for COVID-19 and treatment services with a primary COVID-19 diagnosis, including:

    • specimen collection, diagnostic and antibody testing;
    • testing-related visits in the following settings: office, urgent care, emergency room, or via telehealth;
    • treatment, including office visit (including via telehealth), emergency room, inpatient, outpatient/observation, skilled nursing facility, long-term acute care (LTAC), acute inpatient rehab, home health, DME (e.g., oxygen, ventilator), emergency ground ambulance transportation, non-emergent patient transfers via ground ambulance, and FDA-approved drugs as they become available for COVID-19 treatment and administered as part of an inpatient stay; and
    • FDA-approved vaccine, when available.

    Services not covered by traditional Medicare will also not be covered under this program. In addition, the following services are excluded.

    • Any treatment without a COVID-19 primary diagnosis, except for pregnancy, when the COVID-19 code may be listed as secondary
    • Hospice services
    • Outpatient prescription drugs

    How much will I be reimbursed?

    Reimbursement will be based on current-year Medicare fee schedule rates except where otherwise noted.

    Reimbursement will be based on incurred date of service.

    For more information, including video and user guides:

    Support

    Our service staff members are available to provide real-time technical support as well as service and payment support. Hours of operation are 8 a.m. to 8 p.m. Monday-Friday in the caller's local time zone.

    Provider Support Line: (866) 569-3522