Be Aware: Some Providers Are Getting Shortchanged on COVID-19 Vaccine Reimbursements

Be Aware: Some Providers Are Getting Shortchanged on COVID-19 Vaccine Reimbursements

First the urgent care industry saw itself cut out of the distribution chain for COVID-19 testing supplies. Next, it saw vaccines go preferentially to go health systems, public health organizations, and chain drugstores and big box stores. Now, as it continues to come back from those oversights, there are reports that UnitedHealth Group is undercutting the reimbursement rate set by the Centers for Medicare and Medicaid Services for immunizing patients against SARS-CoV-2. They’re not legally …

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UnitedHealthcare Will Stop Covering Some ED Visits. Could Urgent Care Benefit?

UnitedHealthcare Will Stop Covering Some ED Visits. Could Urgent Care Benefit?

When even the headline of one of Yahoo News’s rotating lead stories notes “backlash” against a decision made by a health insurer, it’s not a good week for the company’s image. However, UnitedHealthcare’s announcement that it’s going to start looking long and hard at emergency room visits—and denying or reducing payment on claims deemed to be nonemergent—could wind up benefiting the urgent care industry. In a network bulletin posted on its website, UHC announced it …

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Are You Being Fairly Reimbursed for Testing or Vaccinating the Uninsured for COVID-19?

Are You Being Fairly Reimbursed for Testing or Vaccinating the Uninsured for COVID-19?

Whether or not you’ve participated in the U.S. Department of Health and Human Services’ program to cover the cost of administering COVID-19 tests to uninsured patients to date, take note that HHS is extending the program to include vaccination. The agency is hosting a webinar on Tuesday, April 13 at 2 pm, Eastern to explain the steps for using the program, including how to enroll as a provider participant, check patient eligibility, submit patient information …

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When Will CMS Boost Reimbursement for the COVID-19 Vaccine? (How Does ‘Now’ Sound?)

When Will CMS Boost Reimbursement for the COVID-19 Vaccine? (How Does ‘Now’ Sound?)

The Centers for Medicare & Medicaid Services has instituted a course correction regarding reimbursement for COVID-19 vaccination. As of March 15, CMS has increased the amount from approximately $28 to $40 for the single-dose vaccine and approximately $45 to $80 for those requiring the two-dose schedule. CMS says the decision to increase reimbursement reflects the growing body of information about the actual costs involved in administering the vaccine across different settings by an array of …

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Are You Getting Reimbursed for Counseling Patients to Self-Isolate? Now You Can

Are You Getting Reimbursed for Counseling Patients to Self-Isolate? Now You Can

When you spend time with a patient and counsel them to self-isolate due to concerns over COVID-19, you’re using the expertise you’ve developed through years of training and treating others. Up until now, however, there’s been no mechanism to reimburse you for that that time, which you could be spending to provide revenue-generating care. Recognizing this, the Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention have announced that payment …

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If You Test or Treat Uninsured Patients for COVID-19, Make Sure You Get Paid. Here’s How

If You Test or Treat Uninsured Patients for COVID-19, Make Sure You Get Paid. Here’s How

The Department of Health and Human Services, under the Families First Coronavirus Response Act and the Coronavirus Aid, Relief and the Economic Security (CARES) Act, has launched a portal specifically designed to ensure healthcare providers who have tested or treated uninsured patients for COVID-19 are compensated for those services. Claims are reimbursed “generally at Medicare rates,” according to HHS. Claims related to care provided on or after February 4, 2020 can be submitted through the …

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Data: Antibiotic Stewardship Efforts Don’t Seem to Apply to Some Medicaid Patients

Data: Antibiotic Stewardship Efforts Don’t Seem to Apply to Some Medicaid Patients

Urgent care has taken a leadership position among healthcare settings when it comes to fighting antibiotic resistance. The Urgent Care Association initiated an Antibiotic Stewardship Commendation Program, wherein urgent care operators are recognized for fulfilling certain criteria demonstrating responsible antibiotic prescribing. And some large urgent care companies have instituted strict internal controls to ensure antibiotics are prescribed according to accepted guidelines. All those efforts, geared toward stemming antibiotic resistance, may be being undermined by inappropriate …

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New Anthem App Could Cut Out Live Providers All Together

New Anthem App Could Cut Out Live Providers All Together

The last time Anthem made big news relevant to the urgent care community, it was something of a blessing: the insurer announced it was going to deny claims for emergency room visits that wound up being for nonemergent complaints, possibly incentivizing patients to go to urgent care instead. The reception might not be so warm for the company’s latest initiative, though. Anthem says it’s going to launch a new app that will allow its members …

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UCA Offers Payers Rationale for Higher Reimbursements, Broader Scope for Urgent Care

UCA Offers Payers Rationale for Higher Reimbursements, Broader Scope for Urgent Care

Urgent care centers offer convenience and quality care that patients need, at a cost that insurers should appreciate (especially when the alternative would be an emergency room bill). You know this, but sometimes it may seem like private and public payers alike don’t have a clue. The Urgent Care Association has put together a rationale to drive these points home in a position statement aptly titled Urgent Care Centers Deserve Fair Reimbursement for the Services …

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Telemedicine Reimbursements Are Expanding Along with Utilization; Is It Time to Try It?

Telemedicine Reimbursements Are Expanding Along with Utilization; Is It Time to Try It?

State support for reimbursing telemedicine providers is growing at a fast and furious pace—as is consumer adoption of telemedicine services. According to the American Telemedicine Association’s 2019 State of the States Report: Coverage and Reimbursement, 40 states and the District of Columbia have adopted substantive policies or received awards to expand telehealth coverage and reimbursement—just since 2017. In doing so, they’re also increasing access for patients and incentivizing providers (including urgent care operators) to jump …

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