4/19/2022 - Advanced Eligibility Options for HRSA Claims
Now that HRSA has nearly expired their funding, it is important for us to decide what to do with the outstanding claims. I am concerned that we have some clients that billed to HRSA because it was too difficult or was unable to get the patient to provide their insurance information or the CORRECT insurance information. If this is the case...then we have claims hanging out here that won't pay through HRSA Uninsured and the time is ticking away to beat the timely claims filing limit of 365 days for whomever they are insured with.
Recently, Electronic Billing Services Inc, engaged an Advanced Eligibility option called Insurance Discovery, that will allow us to potentially locate insurance and policy numbers for these patient's. It is not a free service! The cost for Insurance Discovery is $1.25 per transaction. There is no guaranty that an insurance will be found, but the success rate has been running around 80%. That success rate may be a lower if, in fact, these patients are REALLY HRSA Uninsured patients. Only you know how hard your team worked to make sure the correct insurance or how many patient refused to provide it to you.
My thoughts are that there is a great opportunity to salvage some of these HRSA Uninsured claims by running them through the Insurance Discovery process and bill the patient's insurance that is found. Since there is a cost involved, I need you to make the decision on whether you want us to use the Insurance Discovery option on your claims. It will take approximately 7-10 days to get the account set up. It is a "pay as you use" program with no set up costs and no minimums.
If you are interested in having your HRSA claims ran through this Insurance Discovery process, you must send an email to email@example.com to request this process be implemented.
In addition...please continue to reach out to your congressmen/women to ask for additional funding for the HRSA Unisured program authorized in the CARES Act. The facts are that HRSA advised that claims had 365 days for timely filing processing. The window they provided to get the claims processed in was short and unrealistic for the volume of claims still pending. Some claims were erroneously denied or rejected for processing by the UHC contractor. At a minimum, they funds should be authorized by Congress to pay for ALL the claims "Administered or Dispensed" up to a particular date and NOT just going by the submitted date. I believe the fair date to use would be through the end of the "Pandemic Period". Another good point to make is that during this pandemic, our government has paid for vaccines for non-US citizens and/or residents. Many people crossed our boarders to get a FREE vaccine through the HRSA program. Now, our own US citizens that are uninsured are paying that price. The uninsured of our country are some of the most vulnerable citizens.