Cho 2 Số 59 Và 19

     

Important Update Regarding Submission of Claims

The Uninsured Program stopped accepting claims due lớn a lack of sufficient funds. Confirmation of receipt of your claim submission does not mean the claim will be paid. No claims submitted after March 22, 2022 at 11:59 p.m. ET for testing or treatment will be processed for adjudication/payment. No claims submitted after April 5, 2022 at 11:59 p.m. ET for vaccine administration will be processed for adjudication/payment.

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gamize.vn anticipates that claims submitted by the deadline may take longer than the typical 30 business day timeframe to lớn process as gamize.vn works to lớn adjudicate và pay claims subject khổng lồ their eligibility.

*Submitted claims will be paid subject khổng lồ the availability of funds.

For additional information, visit:

Reimbursement Payment Data

View the list of providers who have received a reimbursement from the gamize.vn COVID-19 Uninsured Program.


About the Program

The U.S. Department of Health & Human Services (HHS), provides claims reimbursement to lớn health care providers generally at Medicare rates for testing uninsured individuals for COVID-19, treating uninsured individuals with a COVID-19 diagnosis, and administering COVID-19 vaccines to lớn uninsured individuals.

A separate program, the gamize.vn COVID-19 Coverage Assistance Fund, is available lớn reimburse providers for COVID-19 vaccine administration to lớn underinsured individuals whose health plan either does not include COVID-19 vaccination as a covered benefit or covers COVID-19 vaccine administration but with cost-sharing.

View Frequently Asked Questions.

How It Works

Health care providers who have conducted COVID-19 testing or provided treatment for uninsured individuals with a COVID-19 primary 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 lớn available funding. Providers can also request reimbursement for COVID-19 vaccine administration. Steps will involve: enrolling as a provider participant, checking patient eligibility, submitting patient information, submitting claims, & receiving payment via direct deposit.

To participate, providers must attest lớn the following at registration:

You have checked for health care coverage eligibility và confirmed that the patient is uninsured. You have verified that the patient does not have coverage through an individual, or employer-sponsored plan, a federal healthcare program, or the Federal Employees Health Benefits Program at the time services were rendered, and no other payer will reimburse you for COVID-19 vaccination, 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.

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For Whom Can Claims Be Submitted

Providers may submit claims for individuals in the U.S. Without health care coverage.

What"s Covered

Reimbursement under this program will be made for qualifying testing for COVID-19, for treatment services with a primary COVID-19 diagnosis, & for qualifying COVID-19 vaccine administration fees, as determined by gamize.vn (subject khổng lồ adjustment as may be necessary), which include the following:

Specimen collection, diagnostic and antibody testing.Testing-related visits including in the following settings: office, urgent care or emergency room or telehealth.Treatment: office visit (including telehealth), emergency room, inpatient, outpatient/observation, skilled nursing facility, long-term acute care (LTAC), rehabilitation care, home health, durable medical equipment (e.g., oxygen, ventilator), emergency ambulance transportation, non-emergent patient transfers via ambulance, and FDA-licensed, authorized, or approved treatments as they become available for COVID-19 treatment.Dispensing fees for FDA-licensed or authorized outpatient antiviral drugs for treatment of COVID-19.Administration fees related to lớn FDA-licensed or authorized vaccines.

Claims will be subject khổng lồ Medicare timely filing requirements.

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, except for the dispensing fee for FDA-licensed or authorized outpatient antiviral drugs for treatment of COVID-19.

All claims submitted must be complete & final.

Claims Submission

Information on claims submission can be found at: coviduninsuredclaim.linkhealth.com

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Claims Reimbursement

Claims for reimbursement will be priced as described below for eligible services (see coverage details above).

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 & updates to existing codes is made in accordance with the Centers for Medicare và Medicaid Services (CMS).For any new codes where a CMS published rate does not exist, claims will be held until CMS publishes corresponding reimbursement information.

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Customer Support

Our contractor’s service staff members are available khổng lồ provide real-time technical support, as well as service and payment support. Hours of operation are 8 a.m. Lớn 10 p.m. Central Time, Monday through Friday.

Provider support Line: 866-569-3522 for TTY dial 711

Archived Resources

Patient Fact Sheet: gamize.vn COVID-19 Uninsured Program Fact Sheet (English PDF - 173 KB)Provider Fact Sheet: What Providers Need lớn Know About COVID-19 Vaccine Fees và Reimbursements (English PDF - 170 KB)April 13, 2021 Webcast: Getting Started with the gamize.vn COVID-19 Uninsured Program