Temporary Cost Share Waivers Extended Due To COVID-19
The Covid-19 National Public Health Emergency has been extended as of July 19th, 2021 to October 17th, 2021; this will affect the temporary provisions that have already been in place for testing and patient visits that are Covid related. The temporary provisions were expected to be just that, temporary. The PHE was scheduled to end July 19th, however, due to the new Delta variant of the virus, new precautions have been put into effect and the emergency has been extended.
Continuing from February of 2020, United Healthcare will continue to waive cost-sharing for in and out-of-network Covid-19 testing and Covid related patient visits, including telehealth visits and antibody testing. This does not include routine or surveillance testing (i.e. testing in order to return to the workplace, travel, or entertainment purposes). Cost -sharing only applies to tests that are physician, or licensed health care professional, ordered and administered. Covid-19 testing that has been purchased over the counter that will not have been ordered or administered by a healthcare professional will not be covered by the member’s insurance plan, however, the patient may choose to use their health savings account (HSA). If an over the counter test has been ordered, the patient may submit a claim for reimbursement. Some services that are outside of the Covid-19 scope can continue to be done through telehealth, however, there are no cost-sharing waivers in effect at this time and will continue to be the member’s responsibility. Please reference the links below for more information on what services still fall under the umbrella of cost-sharing waivers.
During the Public Health Emergency, United Healthcare will not require a referral for an emergency for those with a Medicare Advantage plan, as well as others. Again, please follow your states specific guidelines as they may vary from state-to-state. In regards to credentialing and recredentialing, “these are consistent with National Council on Quality Assurance (NCQA) standards, as well as any specific state and federal regulations for participation in Medicare and Medicaid programs. Some states may have additional requirements as part of the credentialing and recredentialing process,” (United Healthcare Services, Inc.). Any radiology services that are performed related to potential Covid-19 exposure or symptoms does not require prior-authorization, but providers are asked to submit particular CPT codes when billing. Please reference the Covid-19 Temporary Provisions link for more information, specifically page 6, 12, 13, and 18.
Please refer to your states specific Covid-19 website or hotline for more information on Medicaid variations state-by-state.
For more information, please follow the links below.
Covid-19 Information and Resources | Covid-19 Temporary Provisions
Sources:
“Covid-19 Information and Resources.” UnitedHealthcare Provider, United Healthcare Services, Inc., 19 July 2021, www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19.html.
“Covid-19 Temporary Provisions.” Uhcprovider.com, United Healthcare Services, Inc., 19 July 2021, www.uhcprovider.com/content/dam/provider/docs/public/resources/news/2020/covid19/COVID-19-Date-Provision-Guide.pdf?cid=em-providernews-PCA12102634-jul21.