Medical billing for COVID-19 Testing & Treatment

For testing and reimbursement protocols and guidelines for medical billing are based on guidance from the Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), state and federal governments, and other health agencies. Caregivers should work with local and state health departments to synchronize testing.

Diagnosis of the presence of virus and potential exposure help in the treatment of the diseases. United Healthcare plans do not cover COVID-19 observation testing, which is used for public health or social purposes like coming back to the workplace, education, travel, or entertainment. These tests are only covered when required by applicable law and adjudicated in accordance with the member’s benefit plan.

Tests must be FDA authorized without any cost of sharing. FDA-authorized tests include the tests that are approved for the patient used through pre-market approval or emergency use pathways. The tests that are developed and administered in accordance with FDA specifications or through state regulatory approval are undertaken by the medical billing for Covid-19.

This coverage of insurance applies to both in-network and out-of-network tests for Medicare Advantage, Exchange, and Employer-sponsored health plans. For individuals enrolled in the United Healthcare Community state variations and regulations may apply during this time.

If members receive medical services or advice for other conditions at the same time as receiving a COVID test, then cost-sharing will be adjudicated in accordance with the member’s health plan and they will be responsible for any co-pay, coinsurance, deductible, or other out-of-network costs.

United Healthcare has requested all the physicians and health care professionals who carry out and bill for COVID-19 antibody tests to register the test(s).

Licensure requirements vary following the variation of state. In some states, the health care professional, like a nurse practitioner, may have the appropriate licensure for ordering a test. The referring to state-wise licensure is required for suitable supervision.

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