How it works
Health care providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 can request claims reimbursement online will be reimbursed at Medicare rates.
To participate, providers must attest to the following at registration:
- You have checked for health care coverage eligibility and confirmed that the patient is uninsured. You have verified that the patient does not have coverage such as individual, employer-sponsored, Medicare or Medicaid coverage, and no other payer will reimburse you for COVID-19 testing and/or care for that patient
- You will accept defined program reimbursement as payment in full.
- You agree not to balance bill the patient.
- You agree to program terms and conditions and may be subject to post-reimbursement audit review.
Coverage
For services provided after February 4, 2020, providers will be eligible for reimbursement for COVID-19 testing and testing-related visits for uninsured individuals, also uninsured individuals with COVID-19 diagnosis confirmed by
- Specimen collection, diagnostic, and antibody testing
- Testing-related visits including the following settings: office, urgent care or emergency room or via telehealth
- Treatment, including office visit (including telehealth)
Services not covered by traditional Medicare will also not be covered under this program. In addition, the following services are excluded:
- 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.
Steps involved include
- Enrolling as a provider participant
- Checking patient eligibility
- Submitting patient information
- Submitting claims
- Receiving payment via direct deposit
Claim Submission
- Create an Optum ID
- Visit https://coviduninsuredclaim.linkhealth.com/
- Set up Optum Pay Automated Clearing House
- Add Provider Roster and Attest
- Submit Claims for Reimbursement
Claims Reimbursement
- Claims for reimbursement will be priced as described below for eligible services.
- Reimbursement will be based on current year Medicare fee schedule rates except where otherwise noted.
- Reimbursement will be based on incurred date of service.
- Publication of new codes and updates to existing codes will be made in accordance with CMS.
- For any new codes where a CMS published rate does not exist, claims will be held until CMS publishes corresponding reimbursement information.
What we need from you
- First and last name
- Date of birth
- Gender
- *SSN and state of residence; if not available, enter state identification / driver’s license
- Date of service for physician, lab or facility outpatient services.
- Date of admission and date of discharge for facility inpatient services.
- Address (optional)
- Middle initial (optional)
- Patient account number (optional)
A temporary Member ID will be issued. The temporary member ID will be eligible for 30 days from the date of approval. Claims eligible for submission using the temporary member ID will require a date of service (outpatient) or date of discharge (inpatient) between February 4, 2020, through the expiration date of the temporary ID.
Please feel free to contact us at [email protected] with questions or concerns.