COVID-19: Accelerated Payments During the Public Health Emergency

Introduction

During the COVID-19 public health emergency, urgent care clinics and other healthcare providers may be challenged to keep revenue flowing so they can continue to offer essential medical care. CMS expanded its Accelerated and Advance Payment Program in accordance with the CARES Act. To find out if you qualify for accelerated or advanced payments, check out the guidelines below from our experts.

Disclaimer Regarding Guidance: The information provided is intended to provide general guidance. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice from a healthcare consultant, legal counsel or another professional advisor

In no event, will Experity be liable for any loss or damage including without limitation, indirect or consequential loss or damage, or any loss or damage whatsoever arising from loss of data or profits arising out of, or in connection with, the use of this guidance.

This is a living document that will be updated as this situation evolves. This version is current to what we know on April 27, 2020 at 8:34 am.

The Centers for Medicare & Medicaid Services (CMS) suspended this program for Part B providers on 04/26/2020.

Fact Sheet: Expansion of the Accelerated and Advance Payments Program for Providers and Suppliers During COVID-19 Emergency

CMS expanded its Accelerated and Advance Payment Program for the public health emergency in accordance with the Coronavirus Aid, Relief and Economic Security (CARES) Act. CMS was authorized to provide accelerated or advance payments during the period of the public health emergency to any Medicare provider who submits a request to the appropriate Medicare Administrative Contractor (MAC) and meets the required qualifications.

Overview

Qualifications

• Billed Medicare for claims within the last 180 days
• Not be in bankruptcy
• Not be under active medical review or program integrity investigation
• Not have any outstanding delinquent Medicare overpayments

Amount

• Providers could request a specific amount using an Accelerated or Advance Payment Request form provided on each MAC’s website.
• Most providers could request up to 100% of the Medicare payment amount for the previous three-month period. Clinics can apply as a group instead of individual providers.
• Payments were issued within seven (7) calendar days of the request.

Repayment

Repayment of the accelerated/advance payments will begin 120 days after the date of issuance of the payment. Providers will have 210 days from the date of the payment to repay the balance.

Providers will receive full payments for their claims during the initial 120-day period.

The recoupment process will begin at the end of this 120-day period.

At his point, all new claims will be offset to repay the accelerated/advanced payment. No Medicare funds will be received until this payment is paid in full.

Operational Steps

This section is specific to our Experity RCM clients.

These steps are the same for clients on either the Practice Velocity or DocuTAP system.

The client was responsible to notify Experity RCM of the payment amount.

• If Experity has bank access to the Medicare depository account, we will be aware of the amount.
• If Experity does not have access to the Medicare depository account, the client is required to provide the total amount to RCM.

This payment amount will be included on your RCM invoice separately with special deferred payment terms to extend payment to 120 days

The Experity payment posting team will track the total amount paid and all subsequent offsets to manage the open/used amounts.

DocuTAP Posting

• Received funds will be posted in DT as AP Batch Adjustment and will be included in total payments
• Each Medicare offset check will be posted as a batch adjustment amount to offset this amount with the AP reason code
• Reporting can be obtained as needed by running a batch adjustment report and sorting by reason code of AP.

Practice Velocity Posting

• Received advancement funds will be posted in PVM to the account for the patient with the first name ADVANCED MEDICARE and the last name PAYMENT.
• The advance payment will remain on this account as a credit until we receive the offset remits.
• When the offset remit is received the payment is applied to the appropriate invoice using the adjustment reason Advanced MC Payment Recoup Cred.
• The exact dollar amount that is used a credit must be debited off the advanced Medicare payment account using the adjustment reason Advanced MC Payment Recoup Deb.
• Reporting can be obtained as needed by running an adjustment report and sorting by adjustment reason.

For updates on this topic and more, go to Experity COVID-19 Resources.