HRSA Program Provides COVID-19 Coverage for the Uninsured

As schools prepare to reopen across the country, practitioners and suppliers must prepare for an influx of patients infected with COVID-19.  Many of those patients may not have health insurance that covers treatment. Fortunately, the Health Resources & Services Administration (HRSA) COVID-19 Uninsured Program provides reimbursement, subject to available funding, for the treatment of uninsured patients with COVID-19 or related complications. Here is how it works.

Supplier Registration

Interested suppliers must complete the registration process before submitting eligible claims for reimbursement. UnitedHealth Group (United), the same organization that dispersed Provider Relief funds on behalf of HHS, administers the uninsured benefit. United uses their Optum portal to process claims, so suppliers that do not already have an Optum ID must sign up for one. 

Suppliers must agree to:

• Research and confirm:
  • Patients do not have insurance coverage (including individual, employer-sponsored, Medicare, or Medicaid coverages), and
  • No other payer will reimburse for COVID-19 care.
• Accept claim reimbursement (at Medicare rates) as payment in full.
• Not balance bill customers.
• The program terms and conditions.

Suppliers are also required to acknowledge claims are subject to audit.

Creating a Patient Roster

Prior to submitting claims, suppliers must login to the Optum portal and add each uninsured patient to a roster with basic demographics. Suppliers can manually key each patient one-at-a-time or upload patients in batches using a template CSV file. Template fields include the following:

• Billing TIN Number*
• Patient First Name*
• Patient Middle Initial
• Patient Last Name*
• Patient Date of Birth (MM/DD/YYYY)*
• ID Type (SSN, State ID, No ID)*
• ID Number
• Patient Gender (M/F)
• Patient Account Number
• Patient Street Line 1
• Patient Street Line 2
• Patient City
• Patient State*
• Patient Zip Code
• Service Type (Professional, Institutional Outpatient, Institutional Inpatient)*
• Date of Service (MM/DD/YYYY)
• Date of Admission (MM/DD/YYYY)
• Date of Discharge (MM/DD/YYYY)

Suppliers should register only those beneficiaries that have a diagnosis of COVID-19 and receive treatment for a COVID-19 complication on or after February 4, 2020. To populate the roster, suppliers must collect the following:

• Social Security number.
• State of residence, or a state issued ID/driver's license.

The CSV template requires suppliers to enter the service date, but suppliers should leave the fields for the date of admission and discharge blank, as those only apply to institutional claims. Suppliers must also certify that none of the patients on the roster have insurance coverage at the time of service.

Submitting Claims

Within 24 hours of receiving a new roster, United will assign a temporary member ID to each patient that suppliers can use to submit electronic claims for reimbursement. Suppliers must submit all claims electronically through approved clearinghouses using payer ID 95964.
HRSA published a 40-page document explaining various claim processing edits and rejection reasons. Otherwise, the program should reimburse approved claims within seven to 10 days of receipt.

The COVID-19 Uninsured Program Portal User Guide and frequently asked questions document provide additional information about the program. Suppliers can also call 866-569-3522 Monday through Friday between 8:00 AM and 8:00 PM (in the caller's local time zone) for technical and payment support. 

SOURCE LINKS
https://coviduninsuredclaim.linkhealth.com/
https://coviduninsuredclaim.linkhealth.com/static/HRSA%20COVID-19%20Uninsured%20Program_Clearinghouse%20Partners.pdf
https://www.kff.org/policy-watch/limitations-of-the-program-for-uninsured-covid-19-patients-raise-concerns/