Posted in My services, Training, Updates

NC Primary Care Providers can get paid for COVID-19 testing of Uninsured Patients

On 10/30/2020- NC HHS Department has created an online portal for Primary Providers to submit COVID-19 claims for uninsured patients.

This is a first-come first-serve reimbursement to primary care providers who are providing COVID-19 related primary care services to uninsured individuals living in North Carolina*. Per the federal CARES act.

In order to qualify the provider must be:

  1. Primary Care
  2. Operate in North Carolina
  3. Participate in NC Medicaid Program
  4. Be registered in NCTracks payment portal

AND

Providers must attest to the following at registration:

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

* Providers will accept defined program reimbursement as payment in full

• Providers agree not to balance bill the patient

• Providers agree to program terms and conditions and may be subject to post-reimbursement audit review

Reimbursement:

Providers will receive $150 per eligible visit.

Reimbursement Process:  

1. PCPs should confirm their enrollment as a provider in the NCTracks system. Enrollment can be completed in the portal.

2. PCPs should perform COVID-19 related services (e.g. follow-up care) for patients as usual.

3. PCPs must ensure the patient does not have insurance to be eligible for the program, PCPs should use the NCTracks portal to complete the attestation form to file the claim. Attestation will serve as verification of eligibility.

NCTracks Attestation Form includes the following language:

By submitting this transaction to the NC Department of Health and Human Services, I attest that the service performed is accurately represented as shown, and the patient was uninsured, and the service was a COVID-19 related primary care service. I further attest that claims have been either submitted to the HRSA portal and denied or were not submitted because they were ineligible for HRSA reimbursement. I understand this transaction is a request for payment from CARES Act funding and is subject to audit by the Office of the State Auditor and other oversight organizations.

4. PCPs should regularly file claims in the provider portal. If the claim has been successfully filed in NCTracks and there are still funds available, PCPs will be reimbursed in subsequent NCTracks check writes issued by the Division of Health Benefits.

Official Press Release from NCHHS, please click here!

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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