Coronavirus (COVID-19)

We're here to support you and our members

Thank you for your tireless efforts to care for our members and the people in our communities during this global pandemic. Our employees continue to work remotely and remain highly focused on planning and readiness to ensure we provide seamless service to you, our members and customers.

Quick links

Telehealth visits

Everything you need to know to see your patients by phone or video

Caring for our members

Coverage for COVID-19 treatment, adjustments to pre-authorization and our quality and incentive programs

Testing and treatment

COVID-19 specimen collection, testing, treatment and claims submission

Medications

Vaccines, medication pre-authorizations and extended day supply

Claims payment

Expedited claims payment
We have expedited claims payment to seven days on average.

Medicare claims payment updates
As part of the Coronavirus Aid, Relief and Economic Security (CARES) Act, the Centers for Medicare & Medicaid Services (CMS) implemented temporary updates to claims payments.

  • CMS reinstating sequestration payment adjustment: CMS suspended the sequestration payment adjustment for Medicare claims for dates of service from May 1 to December 31, 2020. CMS is reinstating the sequestration payment adjustment for Medicare claims for dates of service beginning on January 1, 2021. To align with CMS, we will also be reinstating the sequestration payment adjustment for our Medicare Advantage claims with dates of service beginning on January 1, 2021. Note: For inpatient services, it is based on discharge date.
  • CMS applying a 20% increase to the MS-DRG weight for discharges of an individual diagnosed with COVID-19: As part of the CARES Act, CMS is applying a 20% increase to the Medicare Severity Diagnosis Related Group (MS-DRG) weight for discharges of an individual diagnosed with COVID-19 for discharges beginning on or after January 27, 2020. Therefore, we are applying this increase for our Medicare Advantage claims for discharges beginning on this date.

Medical record requests
If your office is unable to send requested medical records to us via fax or mail, view these steps to submit medical records (PDF) for provider appeals and clinical audits using a secure file transfer protocol (SFTP) site.

For provider appeals, you can also use the SFTP site to upload your appeal request and supporting documentation.

Credentialing providers

Temporary providers and expedited credentialing

During this health emergency, we are allowing an exception to our Locum tenens policy and expediting credentialing to help meet emerging demands for health care providers and to ensure that our members have access to care.

Locum tenens
We are making the following exceptions to our Locum tenens policy to allow a provider to identify and authorize care for his or her patients by another provider, during this pandemic:

  • The use of a locum tenens provider by a participating provider has been expanded to 180 days during this emergency.
  • A locum tenens can have a valid license in a different state than the one in which they are practicing in.

Expedited credentialing
If your practice has been directly impacted by COVID-19, please:

View information below regarding temporary updates to telehealth.

Contact information for the state health department

Providers should notify both infection control personnel at their health care facility and their local or state health department in the event of a person under investigation (PUI) for COVID-19.

State

Contact

Form and information

Washington

Washington State Department of Health communicable disease epidemiology staff.

(206) 418-5500

Coordinate testing with Washington State Department of Health for individuals who meet the person under investigation criteria.

Idaho

Bureau of Communicable Disease Prevention, Epidemiology

(208) 334-5939

Report patient information to the number by phone. Consult with your public health district or the Bureau of Communicable Disease Prevention Epidemiology Section before collecting specimens for 2019-nCoV testing. Learn more on the Idaho Department of Health and Welfare website.

Oregon

Oregon Health Authority: On-call epidemiologist (until investigative guidelines are published)

(971) 673-1111

To arrange for testing of an Oregon patient, please contact your local health department to obtain approval through Oregon Health Authority and arrange for shipping to the Oregon State Public Health Laboratory.

Utah

Utah 24-hour urgent event and disease reporting

1 (888) EPI-UTAH (374-8824)

If you are a health care provider evaluating a person for COVID-19, contact the Utah department of health immediately.

Financial resources for providers during COVID-19

Congress just passed new legislation to provide help during this crisis. Include below is information on new and expanded resources to assist you as both a provider and a small business employer.

New grants for frontline support
A new Public Health and Social Services Emergency Fund includes an initial $100 billion for unreimbursed health care-related expenses or lost revenues that are attributable to COVID-19, as well as for personal protective equipment.

More details will be released soon by the Assistant Secretary for Preparedness and Response at the U.S. Department of Health and Human Services (HHS).

HHS is expected to review applications and make payments on a rolling basis, and the application process likely will require a statement of need and a valid tax identification number (TIN).

Tax relief for wages and benefits
Under the new law, physician group practices, clinics and even non-profit community health centers may be able to take advantage of tax credits.

Businesses forced to suspend operations or that have seen gross receipts fall by 50% from the previous year are eligible. Many practices are seeing a loss of revenue as appointments are delayed or even canceled due to concerns around COVID-19.

View the IRS Coronavirus Tax Relief page or speak with your accountant or financial advisor for more information and to see whether your practice or center is eligible.

Loan assistance
Businesses with fewer than 500 employees (including sole proprietors, independent contractors and anyone otherwise self-employed) can apply for “paycheck protection” loans to meet payroll and cover certain other expenses like rent and utilities.

If employers maintain their payroll, borrowers can apply for loan forgiveness (PDF). This provision is retroactive to February 15, 2020, to help bring workers who may have already been laid off back onto payrolls.

The new loans are available through private financial institutions (i.e., banks, credit unions) that participate in the U.S. Small Business Administration’s (SBA’s) lending network.

You can download a U.S. Department of Treasury’s application for borrowers (PDF). Visit SBA’s website to find a local partner near you to learn more about this and other programs.

Other resources

For more information, refer to the following resources:

Palliative care resources