Dissecting the HHS COVID-19 uninsured payment portal

June 1, 2020

The following is a column from Vachette CEO Mick Raich

Several years ago, I wrote about how the big national health care companies may be an access point for the development of a national health service. Well, during the COVID crisis one of these companies, Optum and its parent company UnitedHealthcare (UHC), has stepped up to the challenge. They have built the Health and Human Services COVID-19 Uninsured Payment Portal, which allows providers to submit claims for uninsured COVID-19 patients. Providers must sign up for an Optum Identification number (many groups have this if they are contracted with UHC), and then fill out an attestation form stating they are submitting claims for only uninsured patients. 

The provider will then submit the claim to Optum and receive an individual patient identification number. Once this is received, they then can submit the claim. This takes, on average, three days. The provider will then be paid at 100% of the Medicare rate for the test. 

Several items must be noted. First, the money will run out over time unless the new stimulus package adds additional revenue. Second, claims can only be billed from patients after with dates of service after Feb. 4, claims could only be submitted as of May 6, and payment was expected to start as of May 18.  

There are a couple issues I expect we will see with this in the future. Many providers will try to submit claims for patients with co-pays of deductibles when in fact this is only for patients without any insurance. This will need to be audited as it is inevitable claims will slip through the cracks. Furthermore, we have seen several providers call us and want to submit claims to Optum from startup labs who do not even have billing software or billing companies. That is going to end badly. Getting audited by the Office of the Inspector General over this will be ugly, and you can be sure they will be watching these claims closely.

Finally, this gives UHC a leg up on the competition by being the preferred vendor for any uninsured national health care portal that may be developed to replace Obamacare. Further information on the payment portal can be found in the links below. 



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