posted by AHIP
on May 6, 2020
WASHINGTON, D.C. – No one should hesitate to seek testing or treatment for COVID-19 because of concerns about costs. Hospitals, health systems and health insurance providers are working together in that shared commitment. As part of that ongoing partnership, America’s Health Insurance Plans (AHIP) and the Healthcare Financial Management Association (HFMA) have come together to offer voluntary guidance for how care providers should code and bill COVID-19 care delivered in alternate inpatient settings. By adopting these coding practices, health systems and health insurance providers alike can improve the speed and accuracy of payment as well as reduce administrative burden, turning more resources to caring for patients.
Click here to download the voluntary billing guidance for inpatient services.
“We stand with America’s health care heroes on the front lines,” said Matt Eyles, president and CEO of AHIP. “We are committed to working together – because together, we can overcome this crisis.”
Throughout the COVID-19 crisis, health systems have been innovative in making the best use of resources to care for every patient. Alternate care sites have been essential to this response, giving providers more flexibility to meet the evolving needs of testing and treatment. From ambulatory surgical centers to rehabilitation facilities, parking lots to convention centers, every site has played a critical role in COVID-19 response.
New diagnosis and billing codes have been introduced to capture this activity and ensure proper payment. But clinicians and health insurance providers are struggling to keep up with seemingly constant changes in how they are expected to bill and adjudicate claims. This new resource is designed to provide clear and concise guidance for providers to code and bill, and health insurance providers to pay, for services rendered in temporary, alternate sites during the COVID-19 crisis.
“Clinicians have been nimble in adapting to new care settings and the financial side must keep pace,” said HFMA President and CEO Joseph J. Fifer, FHFMA, CPA. “This voluntary guidance will go a long way toward streamlining the COVID-19 billing and payment process, which benefits everyone—most importantly consumers.”
While voluntary, this guidance reflects some legal requirements of the Medicare program, as well as laws such as the Health Insurance Portability and Accountability Act (HIPAA) and the Families First Coronavirus Response Act (CARES Act).
The voluntary billing guidance for inpatient services can be found here. AHIP and HFMA expect to issue voluntary billing guidance for outpatient services soon.
For more information on what health insurance providers are doing to overcome the coronavirus crisis, visit AHIP’s website.
For additional resources on COVID-19, visit HFMA’s website.
AHIP is the national association whose members provide coverage for health care and related services to hundreds of millions of Americans every day. Through these offerings, we improve and protect the health and financial security of consumers, families, businesses, communities and the nation. We are committed to market-based solutions and public-private partnerships that improve affordability, value, access, and well-being for consumers. Visit www.ahip.org for more information.
The Healthcare Financial Management Association (HFMA) equips its more than 56,000 members nationwide to navigate a complex healthcare landscape. Finance professionals in the full range of work settings, including hospitals, health systems, physician practices and health plans, trust HFMA to provide the guidance and tools to help them lead their organizations, and the industry, forward. HFMA is a not-for-profit, nonpartisan organization that advances healthcare by collaborating with other key stakeholders to address industry challenges and providing guidance, education, practical tools and solutions, and thought leadership. We lead the financial management of healthcare.