Reimbursement for Uninsured COVID-19 Services

InsightsClient Alert

As a part of the CARES Act, the Federal Government indicated hospitals will be reimbursed at Medicare rates or better for taking care of uninsured COVID-19 patients. The method of reimbursement and the actual amount of payments are still uncertain. The funding source is suggested to come from the $100 billion fund for hospitals and other healthcare organizations within this Act.

Recognizing the uncertainties of the process at this point, we are suggesting the most important step providers can take now is to identify all COVID-19 related patients. This identification includes inpatients, outpatients, and even services provided by your hospital-owned physician practices. At some point, you may be required to report your uninsured care related to these patients to the government to request or qualify for uninsured payments. We believe the best way to ensure a complete reporting is to assign some type of indicator to each patient at the beginning of their care.

There is a new ICD-10-CM diagnosis code established for COVID-19 patients, U07.1. If you are using this code and your system will allow you to run reports to capture all uninsured patients, then this code could be the identifier for hospital services. It is uncertain if these funds will be used to pay for uninsured patients’ physician services billed on the Form 1500, but we still suggest some identifier to capture these claims.

If you would like to discuss these ideas, please contact our Albany office at (229) 883-7878 or our Atlanta office at (404) 220-8494.

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