COVID-19: CARES Act Uninsured Program Portal

CARES Act Uninsured Program Portal - Blog Header

During the COVID-19 public health emergency, healthcare testing and treatment is essential to containing the spread of this disease. The government has put funding in place through the CARES Act to ensure insurance coverage does not prevent patients from receiving care. Urgent Care centers can file claims through this act to be reimbursed for testing and treating the uninsured. The following is a program overview and provides guidance on enrollment and claims processing for COVID-19 claims for uninsured patients.

Disclaimer Regarding Guidance on Coding and Billing for COVID-19 Related Services. The guidance set forth herein regarding billing for COVID-19 related services is for educational purposes only and is based upon the limited information available to Experity at the time of publication. Nothing contained herein shall be deemed to constitute a representation, warranty or guaranty of proper coding or payment for any particular medical claim. The sole responsibility for proper coding and submission of any particular medical claim remains with you. You should consult with a certified professional coder and an attorney licensed in your state for guidelines specific to your state, contracts and applicable payors.  

This is a living document that will be updated as this situation evolves. This version is current to what we know on April 29, 2020 at 2:09 pm.

The CARES Act Provider Relief Fund includes allocations for coverage of COVID-19 related services to uninsured patients. The program is overseen by the Health Resources & Services Administration (HRSA). The program is administered by United Health Group and it covers the same services as Medicare. However, it is not a United Health or Medicare program and you do not need to be credentialed with either of these payers.

Providers will be reimbursed as long as there is funding for the program.

Overview

Providers will be reimbursed at Medicare rates for COVID-19 related services. If there is no allowable, claims will be held until Medicare publishes an allowable for that CPT.

Covered services are for both suspected and confirmed cases of COVID-19. This includes diagnostic testing (when covered by Medicare), testing-related visits (e.g., a referral to a testing facility) in the office or urgent care, including telehealth. FDA-approved drugs and vaccines will be covered when they become available.

Billing codes can be found at https://coviduninsuredclaim.linkhealth.com/billing-codes.html. Code as you normally would for Medicare with the correct ICD-10 diagnosis to identify the claim as COVID-19 related.

Claims are subject to the same timely filing requirements required by Medicare.

This is for claims starting on February 4, 2020. Providers must agree to:

  • Verify each patient has no other health care coverage.
  • Accept the program payment as payment in full.
  • Confirm the patient was told they will not be billed.
  • Accept the terms and conditions. Claims may be subject to post-reimbursement review.

Payments will be received via direct deposit through Optum Pay™ Direct Deposit to the same bank account on file for United Health Group.

Next Steps for Practices to Complete

Enroll Practice in Program

Today, providers can begin enrolling at https://coviduninsuredclaim.linkhealth.com/get-started.html.

Sign in with your Optum ID and validate your Tax Identification Number (TIN), attest to the questions, and complete the registration. Do not change the banking information currently on file.

If you do not have an Optum ID, you will need to register. This process will take seven to 10 business days to complete.

Information required if you do not have an Optum ID:

  • TIN or Employer Identification Number (EIN)
  • Business name
  • Provider type
  • Name of administrator(s)
  • Contact information
  • Bank name and contact information
  • Financial institution account information
  • Voided check or bank letter
  • Signed and dated W-9

Upload Provider Roster

This will not be available until 05/06/2020. Experity will provide more information when it becomes available.

Obtain Temporary Member IDs

This will not be available until 05/06/2020. Experity will provide more information when it becomes available.

What we do know:

  • Patient information can be loaded one patient at a time or through a batch upload, parameters have not been released.
  • Obtaining temporary member IDs will take one to three business days.
  • Temporary member IDs are only valid for 30 days.
  • Providers will be required to attest to the program requirements.
  • Patients will need to be identified and registered with this new information.

If you are an Experity RCM client, notify your Client Success Manager when these steps are complete. Experity will take care of the additional steps for claims submission.

Additional Steps for Claims Submission

The insurance plan COVID19 HRSA Uninsured Testing and Treatment Fund (payer ID 95964) needs to be added to your dataset with your Optum ID.

All claims must be submitted electronically through your clearinghouse. Claims are not submitted through the Uninsured Program Portal.

Claim submission begins on 05/06/2020.

All claims submitted are final. No corrected claims, late charges, or appeals will be accepted. United Health Group has Smart Edits in place to assist in clean claim submission.

Payment processing will begin on 05/18/2020. There are a number of factors that could cause up to a two-week delay in sending claims (i.e., obtaining temporary member IDs or registering for direct deposit).