A rule to remember when administering COVID-19 vaccines to Medicare Advantage patients

When you administer a COVID-19 vaccine to someone enrolled in a Medicare Advantage plan, you must file the claim with traditional Medicare.

The Centers for Medicare & Medicaid Services requires physicians and other billing clinicians to submit COVID-19 vaccine administration claims for all Medicare beneficiaries to the Medicare Administrative Contractor (MAC) in their area. You must include the patient’s traditional Medicare Beneficiary Identifier (traditional Medicare ID) on those claims. This can be difficult, because many patients enrolled in Medicare Advantage plans do not carry their traditional Medicare ID card with them, and your office may only have the member’s Medicare Advantage ID number on file. This is different than the traditional Medicare ID.

At least one Medicare Advantage provider is taking steps to ease this administrative burden. To make it easier to find a member’s traditional Medicare ID, UnitedHealthcare has added it to the “Eligibility & Benefits” information available on the UnitedHealthcare Provider Portal. If you have an Optum ID, you can access this expanded information 24/7 to assist with your MAC claim submissions. Go to UHCprovider.com and sign in to get started. You can find step-by-step instructions online. If you don’t have an Optum ID, this registration page outlines how to create one. It takes 5–7 business days to complete the registration process.

— Kent Moore, Senior Strategist for Physician Payment, American Academy of Family Physicians

Posted on Feb 24, 2021 by Kent Moore