Medical Billing Services

HRSA Uninsured COVID-19 Program: How to Verify Patient Eligibility?

HRSA Uninsured COVID-19 Program

The COVID-19 Uninsured Program portal is opened by HRSA. Providers who have conducted COVID-19 testing or provided treatment for uninsured individuals with a COVID-19 diagnosis on or after February 4, 2020, can start to file claims for reimbursement for testing and treating the uninsured.

As part of the FFCRA, PPPHCEA, and CARES Act, the U.S. Department of Health and Human Services (HHS), will provide claims reimbursement to health care providers generally at Medicare rates for testing uninsured individuals for COVID-19 and treating uninsured individuals with a COVID-19 diagnosis.

Physicians and other health care providers are true heroes – especially during the COVID-19 outbreak – and HHS is grateful for their continued dedication.

Coronavirus Aid, Relief, and Economic Security (CARES) Act

In April, the U.S. Department of Health & Human Services (HHS) announced that a portion of the $100 billion CARES Act Provider Relief Fund would be used for healthcare-related expenses attributable to the treatment of uninsured individuals with COVID-19.

Families First Coronavirus Response Act or FFCRA

$1 billion from the Families First Coronavirus Response Act (FFCRA) is being used to reimburse providers for conducting COVID-19 testing for the uninsured.

Health care providers who have conducted COVID-19 testing or provided treatment for uninsured individuals with a COVID-19 diagnosis on or after February 4, 2020, can request claims reimbursement through the program electronically and will be reimbursed generally at Medicare rates, subject to available funding, via direct deposit.

Verify Patient Eligibility for Uninsured COVID-19 Program

The requirement to verify an uninsured patient’s eligibility status can be quite difficult for the provider without the help of an insurance verification tool. Some payer sites are costly for manual check and it also slows the patient registration and pre-billing process of providers. This becomes hectic when there are numerous variations in testing sites that have emerged across the USA to meet the surge created by the COVID-19 pandemic.

For patient registration, the patient’s insurance information required at the time of service. It would be difficult, however, to emphasize that this meets the program requirement of verifying that the patient does not have insurance coverage through an individual, or employer-sponsored plan, a federal health care program and that no other payer will reimburse for the COVID-19 testing and/or care for that patient.

Insurance Discovery Tools

ZOLL® AR Boost™:

Insurance discovery tool; that

  • Identify active coverage for more than 10 percent of self-pay accounts
  • Maximize revenue by tapping other payer coverage opportunities
  • Reduce overall self-pay AR
  • Achieve remarkable results. One client identified insurance coverage for 16% of all patients and more than $800,000 in coverage for those who originally presented as self-pay

This tool reports finding billable coverage for as much as 47% of the patients identified as self-pay at the time of registration.

To meet the requirements of the program, a good insurance discovery tool also will reap additional revenue for the provider, as some patients previously identified as self-pay will indeed have commercial coverage.

If you are looking for an insurance discovery tool, you should ensure that the service offered a seamless integration and, ideally, a single source API framework. Best in class tools will not only return billable coverage but suggest whether coverage is primary, secondary, or tertiary and provide a confidence score around the coverage found.

Want more information about COVID-19 claims reimbursement?

Check out these resources:

HRSA COVID-19 Uninsured Program Frequently Asked Questions (FAQ)

COVID-19 Uninsured Program Portal

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