Impact of COVID-19 pandemic on the Global Financial System is outrageous.  Government, Federal Banks and International organizations are planning and implementing new policies to preserve financial stability.  Healthcare Industry and Providers are no exception and facing the ongoing crisis situation.  Advance Payments and Care Act Payments are released now to add more stability to Healthcare Industry.

Medicare Advance Payments

Medicare Advance Payments was announced to assist providers with some quick money to combat the effects of the COVID-19 pandemic.  Providers or suppliers who have Billed Medicare claims with no outstanding delinquent Medicare Overpayments and not under active medical review are eligible to receive this Medicare Advance Payments.  Obviously Provider should not be in bankruptcy.  Medicare Advance payment Request forms vary by Medicare Administrative Contractor. 

• Medicare Advance Payments are Quick Loan to Providers and are to be repaid
  
  
• Repayment will start after 120 days from the Date after Provider received the Medicare Advance Payments
  
  
• Offset from the new claims of the Provider will be Primary method to receive back this Loan from the Provider and CMS will have this Offset process done for 90 days to receive back this Loan amount form the Provider (With Providers allowed to have maximum of their last three month Medicare Payment has maximum Loan Amount.  CMS has considers this 90 days to apply this Offset )

The Care Act Provider Relief Fund

US Government secured nearly $175 Billion to Healthcare Provider and Hospitals to face the current Pandemic situation.  On this $50 Billion is going directly to Medicare Providers across the country.  Let see how this works:

U.S. Department of Health & Human Services is directly working to allocate these funds to Providers.  On the allocated $50 Billion, the initial $30 Billion was targeted to be distributed to 320,000 Providers who bill Medicare fee-for-service. 2019 Medicare yearly payment amount of the Provider or Provider group is the metric to derive the Fund for each Provider or Provider Group.  Below is the standard formula used to derive the Allocated amount to each Provider or Provider Group:

Payment Allocation per Provider = (Provider 2019 Medicare FFS Payments / $453 Billion) x $30 Billion 

U.S. Department of Health & Human Services partnered with United Health Group to deliver these funds.  The automatic payment will come via Optum Bank with “HHSPAYMENTS” as the payment description.   

The additional $20 Billion was targeted to be distributed to 15,000 providers based on the CMS cost reports and revenue submissions to the provider portal.  This distribution started by April 24^th, 2020

COVID-19 Uninsured Program

A portion of relief fund has to be allocated to healthcare providers who have provided treatment for uninsured COVID-19 patients on or after February 4, 2020. 

Looking from Patient Care perspective this program will make sure financial obstacle are not preventing Covid-19 patient from getting the exact care that they need at this time

Providers can complete their initial profile setup thru below HRSA Link

https://www.hrsa.gov/coviduninsuredclaim

The Link will direct to Optum Web-link thru which Provider TIN Verification and basic Provider attestation has to be completed.  Once this initial level of Web-link set up is done.  The Provider will be enabled with an option to upload the Uninsured Patient Details.  Once the Patient Details are uploaded we will receive a unique Member Id# thorough the same Web link in next one or two business days

There is Unique Payer ID assigned for this Program to submit this uninsured claims electronically and all major Clearing houses have activated this Payer id with them.  This way once we have the Member Id received in HRSA Link.  The claim can be submitted through your Practice management electronically to receive Payments.  Below is how the Insurance name has to be updated on Patient Demographics and reflect in Covid-19 Uninsured Claims

COVID19 HRSA Uninsured Testing and Treatment Fund
UnitedHealth Group, Attention: CARES Act Provider Relief Fund
PO Box 31376, Salt Lake City, UT 84131-0376

About e-care

Let us know if you have any additional questions on the Advanced Payments and Cares Act Payments and we can help you understand. E-care India is a reputed HIPAA compliant offshore medical billing company providing exceptional Medical Billing services including Provider Credentialing Services, Insurance eligibility verification, Medical Coding and Revenue Cycle Management services. What differentiates e-care from its competitors is its commitment towards delivering high quality services in a timely manner as per agreed Service Level Agreements (SLA).To know more about our medical billing services, visit us at www.ecareindia.com.