• Piyush Kedia

COVID-19 Billing Process for Uninsured Patients

Updated: May 7


Submitting claims for individuals without U.S. healthcare coverage, for COVID-19 testing or treatments, given by a provider on, or after, February 4, 2020.


Please Note: The Health Resources And Services Administration (HSRA) has authorized the UnitedHealth Group to be the sole administrator of the HSRA COVID-19 Uninsured Program.


The Total Registration process will take 15 -19 Business Days








Step 1: Create an Optum ID Account

  • Optum ID will serve as a unique identifier

  • Create an account using this sign-up link. Can expect to provide the following information:

Enter basic profile identifier details (Name, DoB, Password, etc.) Verify phone # and establish security question responses






Step 2: Validate Taxpayer Identification Number

● This should be the TIN for the facility in which care was provided. If a provider already is contracted and has a Link account through UnitedHealthcare, some of these steps will be auto-populated.

● Need the billing TIN for all facilities or groups but only one person can serve as the administrator per TIN - administrator accepts responsibility to act on behalf of their organization.

● Verification process may take 1-2 days. For inquiries/problems, contact: 866-569-3522






Step 3: Optum Pay Automated Clearing House

Optum Pay is a fully integrated, full service payment and remittance advice solution for all sizes and types of healthcare professionals. Payments are administered through Optum Bank. Process will take 7-10 days.

● The following information will be required:

○ TIN

○ Business name,

○ Provider type

○ Name of administrators

○ Contact information

○ Bank name and contact

○ Financial institution account number

○ Voided check or bank letter

○ Signed and dated W-9 form






Step 4: Adding a Provider Roster


5- 7 Day Verification Process. To commence, you need to access your provider dashboard. You’ll be notified if this step needs to be completed. Providers in the UHG network will most likely skip this step and follow either their CAHQ, My Practice Profile, or roster management process.



  • Using an Excel template, input your roster information into the provided spreadsheet

  • TIPS:

  • Make sure you’re working on the templated Excel file only

  • Enter your TIN and 9-digit with no dashes

  • Drop down menus are available in some sections

If you are a group with individuals, make sure that the relevant entry items across the tabs match perfectly.






Steps 5 & 6: Add & Attest to Patient Roster, Then Submit!


Need to enter & submit patient information. Receive a temporary member ID for each individual after submitting patient information, which will be displayed in the program portal in less than 24 hours.






Step 7: Electronic Payments Received Online

  • Payments will be distributed electronically once the claim is processed and approved for payment. This will be facilitated by Optum Pay.

  • Providers can expect payments in approximately 7 - 10 business days after approval.


Appendix

For diagnostic testing and testing-related services to be eligible for reimbursement, claims submitted for testing-related visits rendered in an office, urgent care or emergency room or via telehealth setting must include one of the following diagnosis codes:



For antibody testing and testing-related services to be eligible for reimbursement, claims submitted for testing-related visits rendered in an office, urgent care or emergency room or via telehealth setting must include one of the following diagnosis codes:




For services related to treatment to be eligible for reimbursement, claims submitted must meet the following criteria:


The COVID-19 diagnosis code must be the primary diagnosis code submitted. The only exception is for pregnancy (O98.5-), when the COVID-19 code may be listed as secondary.

COVID-19 diagnosis code for dates of service or dates of discharge prior to April 1, 2020 need to follow older instructions.


HRSA COVID-19 Uninsured Program Coding


Excluded services includes:

- Any treatment without a COVID-19 primary diagnosis, except for pregnancy when the COVID-19 code may be listed as secondary.

- Hospice services.

- Outpatient prescription drugs.

- Services not covered by traditional Medicare will also not be covered under this program.


Sources: HSRA Communications, Optum Pay, Optum Bank

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