HRSA COVID-19 Uninsured Program Shutdown FAQs

Updated:March 16, 2022

 

Whywill the HRSA COVID-19 Uninsured Program stop accepting claims?

The HRSA COVID-19 Uninsured Program(UIP) will soon stop accepting claims due to a lack of sufficient funds. Theprogram will continue to accept claims for testing and treatment until 11:59 PMon March 22, 2022 and claims for vaccine administration until 11:59 PM on April5, 2022.

Any testingand treatment claims submitted in the Portal after March 22, 2022, will not beadjudicated for payment.

Any vaccineadministration claims submitted in the Portal after April 5, 2022, will not beadjudicated for payment.

 

Whenis the final deadline to submit claims for reimbursement?

The deadlines to submit claims foreach category of service are as follows:

  • Testing claims: March 22, 2022, at 11:59 p.m.     ET
  • Treatment claims: March 22, 2022, at 11:59 p.m.     ET
  • Vaccine administration claims: April 5, 2022, at 11:59 p.m.     ET

Any testingand treatment claims submitted in the Portal after March 22, 2022, will not beadjudicated for payment.

Any vaccineadministration claims submitted in the Portal after April 5, 2022, will not be adjudicatedfor payment.

 

Willeligible claims submitted by the deadline be reimbursed?

Claims submitted by the deadline foreach category of service will be adjudicated and paid subject to theireligibility and the availability of funds.

 

Whatother resources are available to providers and/or uninsured individuals afterthe Uninsured Program winds down?

Alternative resources for uninsuredindividuals who need COVID-19 services or other health care coverage include:

Note: per the Centers for DiseaseControl and Prevention’s Requirements for COVID-19 Vaccination ProgramProviders, providers must continue to administer COVID-19 vaccines at noout-of-pocket cost to recipients.

 

Isubmitted claims before the submission deadline was announced on March 15,2022. Will those claims be paid?

Claims submitted by the deadline foreach category of service will be adjudicated and paid subject to theireligibility and the availability of funds.

 

Whatwill happen if I submit a testing or treatment claim after March 22, 2022?

Testing and treatment claimssubmitted after the deadline will NOT be adjudicated. Regardless of whether thesystem shows your claim as having being received, no testing or treatment claimsubmitted after March 22, 2022, will be processed.

Date Last Reviewed:  March 2022

 

Link to Article:  https://www.hrsa.gov/coviduninsuredclaim/submission-deadline

 

 

 

In-house Medical Billing

Initially, physician’s offices had a person in-house that handled everything having to do with billing for the practice. This person added to the overhead of the office – about 10 – 12% and handled everything from A-Z in the billing process. General knowledge of codes was all that was needed to ensure reimbursement from insurance companies as this was before managed care.

The beginning of managed care brought to the industry fee schedules, preferred provider contracts, the need for pre-authorizations and more. These changes meant a more intensive knowledge of medical codes was required as well as continuing to keep updated as codes were added and deleted.  These changes increased cost and time required to handle billing.

Outsourced to Medical Billing Companies

Initially, physician’s offices had a person in-house that handled everything having to do with billing for the practice. This person added to the overhead of the office – about 10 – 12% and handled everything from A-Z in the billing process. General knowledge of codes was all that was needed to ensure reimbursement from insurance companies as this was before managed care.

The beginning of managed care brought to the industry fee schedules, preferred provider contracts, the need for pre-authorizations and more. These changes meant a more intensive knowledge of medical codes was required as well as continuing to keep updated as codes were added and deleted.  These changes increased cost and time required to handle billing.

At PRM, we pride ourselves on exceptional expertise, dedicated specialists, and exceptional customer service so you can worry less and focus on patient care.

Our Complimentary Consultation is a discovery and feedback initiative built to help practices. You get one on one advice from our experts, plus a report for your practice to use, absolutely free for you.

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In-house Medical Billing

After listening to what clients were asking for, a more robust system was created that covered more than just standard medical billing. This full-cycle revenue management system saved doctors time and money by eliminating the need to have different people handling all other aspects. Revenue Cycle Management includes:

  • Insurance Eligibility – insurance verification and patient eligibility details checked two days ahead of a patient’s appointment ensuring 100% upfront collection.
  • Charge Posting – ensuring demographic information is entered in the system accurately helping to eliminate rejections or denial from the payer which can prolong the reimbursement turnaround time
  • Documentation Review – once visit notes are locked coding team retrieves a random sampling of the weekly visits to review and ensure proper guidelines were followed. We also provide education to the doctor and staff on their usage of CPT/ICD -10 to help them improve on future documentation
  • Claim Submission – claims are reviewed and scrubbed to ensure that all information in the claim is correct to help eliminate a denial
  • Denial Management – when payment for services is denied, we follow up with the insurance carrier to determine if it is a coding error or something else that has facilitated the denial. We complete appeals and add any supporting documentation submitted through your software
  • Payment Posting – critical to the health of your AR – insurance payments posted to patient accounts from EOB’s in the doctor’s system with a turnaround time of 24 to 48 hours. With daily payments accessible via the practice management system
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