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The Biden-Harris Administration is providing free access to COVID-19 vaccines for every adult living in the United States. Accordingly, the Health Resources and Services Administration’s (HRSA) COVID-19 Coverage Assistance Fund (CAF) will cover the costs of administering COVID-19 vaccines to patients whose health insurance doesn’t cover vaccine administration fees or does but typically has patient cost-sharing

About the Program

HRSA will provide claims reimbursement to eligible health care providers at the national Medicare rate for administering Food and Drug Administration (FDA) authorized COVID-19 vaccines under an Emergency Use Authorization (EUA) or FDA-licensed COVID-19 vaccines under a Biologics License Application (BLA) to underinsured individuals.

NOTE:  For Uninsured patients please use the HRSA Uninsured Patient Program

How it Works

Health care providers can request claims reimbursement, through the COVID-19 Coverage Assistance Fund electronically and will be reimbursed at the national Medicare rate for vaccine administration, and for patient charges related to COVID-19 vaccination, including co-payments for vaccine administration, deductibles for vaccine administration, and co-insurance, subject to available funding.

What’s Covered

There is no cost to health care providers for COVID-19 vaccines received from the federal government, therefore, providers are expected to submit a claim for only vaccine administration to the individual’s health plan for payment. Only those claims denied or for which a patient’s health plan assesses charges to the patient related to COVID-19 vaccine administration are eligible for reimbursement and may be submitted to the Coverage Assistance Fund. Those claims include co-payments for vaccine administration, deductibles for vaccine administration, and co-insurance.

Claims Submission

Create an account: https://covid19coverageassistance.ssigroup.com/

Once enrolled, eligible providers and pharmacies can submit claims through their current clearinghouse or submit a claim electronically or manually through the Portal.

Claims Reimbursement Rate

Claims for reimbursement will be priced as described below for eligible services:

Vaccine administration fees will be priced based on national Medicare rates for administering the COVID-19 vaccine (not geographically adjusted) and are outlined below:

For dates of service through March 14, 2021:

  • Administration of a single-dose COVID-19 vaccine – $28.39.
  • Administration of the first dose of a COVID-19 vaccine requiring a series of two or more doses – $16.94.
  • Administration of the final dose of a COVID-19 vaccine requiring a series of two or more doses – $28.39.

For dates of service on or after March 15, 2021:

  • Administration (per dose) of a COVID-19 vaccine – $40.00.

Link to the complete article:  https://www.hrsa.gov/covid19-coverage-assistance 

We understand that your practice needs a swift, reliable revenue stream to thrive. And we know that it takes more than a slick software package to make it happen.  Definitely, It takes the right people. Therefore, we have created unique medical billing services to make your life easier. It is backed by our experience serving physicians since 1995.

We make sure our clients are supported by a billing and collections team carefully chosen for their industry expertise and dedication to customer service. In addition, your PRM team takes full responsibility for the financial health of your practice. If you don’t get paid, we don’t get paid. As a result, this performance-based model keeps our operations lean and focused and help us achieve one of the highest collection rates in the billing industry.

Finally, when you know the right people are handling your revenue cycle, you can relax and focus on what you do best- delivering excellent medical care.

PRM is here to help make life easier for you and your office staff. Join our medical billing company today and enjoy our benefits! Contact Us

Lanny Menendez
Professional Reimbursement Managers