• New opportunity to get paid for treating uninsured COVID-19 patients

    Last week, the Department of Health and Human Services (HHS) unveiled a new website with information about how physicians and others can submit claims requesting payment for treating uninsured COVID-19 patients.

    The website includes a link to the Uninsured Program Portal, which will soon accept claims for payment for uninsured COVID-19 patients who received testing or treatment on or after Feb. 4. Payment will generally be at Medicare rates and, according to the site, will be "subject to available funding."

    The sign-up period for the program began Apr. 27. To request payment, you must verify that patients are uninsured, agree to not balance bill patients, and agree to the program’s terms and conditions. HHS may also subject you to post-payment audit review. You may begin submitting claims electronically on May 6, and payments should begin May 18.

    Payment will be made for qualifying COVID-19 testing and treatment services with a primary COVID-19 diagnosis, including (but not limited to) the following:

    • Specimen collection, diagnostic testing, and antibody testing.
    • Testing-related visits, including in office, urgent care, or emergency room settings, or via telehealth.
    • Treatment, including office visits (whether in-person or via telehealth).
    • Food and Drug Administration-approved vaccine, when available.

    Note that it appears a patient must have a primary diagnosis of COVID-19 to qualify. Thus, if a patient has COVID-related symptoms and receives a variety of tests before the COVID-19 test and the COVID-19 test ultimately is negative, you may not be able to receive any payment from this fund.

    Additional guidance can be found in this frequently asked questions document.

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

    Posted on May 04, 2020 by Kent Moore

    Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.