COVID-19

HIPA COVID-19 Updates

General Membership

Below is a compilation of resources important for all private practices during COVID-19. For Payment Transformation specific information and updates, please visit our Payment Transformation page. If you do not have the password, please outreach your physician liaison

Please note: information is rapidly changing. Where possible, we have included links to working documents that will be updated as needed. Each will have an “last updated” date. Please check
back to these links for future updates.

Pulse Check Survey

If you have not already, please fill out our COVID-19 pulse check survey; 1 per practice. We have been using this data in discussions with key leaders in the community so they are aware of the struggles of independent private practices during COVID-19.

PPE Resources Available

Masks, Sanitizers, Gloves

  • KN95 masks available through HIPA (limited supply)
    Price: $195 for 50 masks
    To order: email Julie@hawaiiipa.com
    Certification: FDA, CE, GB/2606-2006
  • Supplies available via PAC/RIM, free on island deliveries. $0 minimum for Oahu, $150 minimum for NI
    To order: email info@prmedhawaii.com or call (808) 845-6644
    • Gel hand sanitizer (to order, may have shipping delays)
      • HIPA members: $57/gallon; $12.50/16 oz; please tell them you are a HIPA member when ordering for these prices
    • Other supplies: liquid sanitizer, gloves, etc. via price list

‘Iolani Face Shield Project

Head of School, Dr. Timothy Cottrell, and his team have become one of Hawaii’s largest independent producers of face shields, donating thousands locally and across seas. If you would like to order face shields you can contact them via phone at (808) 949-5355 or email info@iolani.org. To learn more, visit their website.

N95 Mask Fitting

The National Guard will be doing N95 fittings for independent physicians through May 31 to ensure proper usage and safety for providers. We have been asked to compile a list of doctors who have N95 masks and need a fitting so the National Guard can be deployed to your offices. This is in preparation for the “post-surge” phase of the State recovery.

How it works: The National Guard will instruct you on proper donning of the N95 mask. They put a hood on you and squirt an aerosol in the hood. They have you look to the right and left and up and down. If you can smell the solution, the mask does not fit. If you would like to be added to the list of those who need fittings please email julie@hawaiiipa.com with your name, address, and availability. If you are in the Queens or HPH networks/buildings, you should have already received notice of them offering their own fittings.

Telemedicine Resources

IMPORTANT CHANGE in the 4/30/2020 CMS Guidance: Per CMS’s most recent press release , Medicare is increasing their reimbursement rates for phone visits. “CMS previously announced that Medicare would pay for certain services conducted by audio-only telephone between beneficiaries and their doctors and other clinicians. Now, CMS is broadening that list to include many behavioral health and patient education services. CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020.”

IMPORTANT CHANGE in the 3/30 CMS Guidance: Use POS 11 for Medicare & Medicare Advantage for Telehealth. If you use POS 02, you will receive 30% less in reimbursement. POS 02 should only be used for non-medicare plans.

HIPA created a quick reference coding and reimbursement guide on each of the visit types, displaying description, consent, reimbursement rates, and codes. We will be updating this document as new policies from CMS and local payers comes out. HIPA also created a telemedicine EMR documentation guide to ensure you capture everything you need in your note to keep you covered.

*These are all working documents. Feel free to bookmark these pages and check back frequently for updates. Check the “last updated” date to ensure you are referencing the most recent version.

Coding for Coronavirus

Updated Guidance on Coding for Coronavirus
Use of CS modifiers for COVID-19 related services to access cost- sharing waiver

The following is from the American Academy of Family Physicians’ website:

Service

Place of Service

Modifier(s)

Office visit related to COVID-19 testing

11 – Office

-CS

Telehealth visit related to COVID-19 testing

11 – Office

-95

-CS

Office visit not related to COVID-19

11 – Office

None

Telehealth visit not related to COVID-19

11 – Office

-95

Virtual Check-In (HCPCS G2012, G2010)

11 – Office

None

E-Visit (CPT 99421-99423)

11 – Office

None

Telephone Evaluation and Management (CPT 99441-99443)

11 – Office

None

Commercial payers are generally following Medicare’s lead in terms of coverage and policy. However, coding guidance varies from payer to payer. The AAFP is tracking payer policies closely. A table of private payer policies and list of frequently asked questions are available on the Academy’s COVID-19: Practice Management Page.

Payor Specific Telemed Guidance

Financial Resources & Revenue Streams for Your Office

CARES Act Loans, Grants & Other CMS Opportunities

We have changed our Fact Sheet on the CARES act loans and opportunities into a working document. Please check back here for updates.
Please also see financial resource guide for more detailed information.

IMPORTANT UPDATE, ACTION NEEDED: DHHS announced its plan for distributing the remainder of the provider relief funds authorized by the CARES Act. They indicated an additional $20 billion was being allocated to Medicare providers – both independent providers and health care/hospital systems. Unlike the first round of funding, you need to take action to receive any money from this allocation. It is important that you act quickly to submit the necessary information as we anticipate this money will go quickly. Only those who received a payment from the first allocation, which would have been an automatic direct deposit prior to Friday, April 24th, are eligible to request this additional funding.

To get stared, you’ll need your practice’s Taxpayer Identification Number or TIN. For details about what information you need to complete the application visit the CARES Act Provider Relief Fund Application Guide.

To apply, visit the CARES Provider Relief Fund Payment Portal. If you have questions, visit the General Distribution Portal FAQs or call the CARES Provider Relief line at 866-569-3522.

IMPORTANT UPDATE: CMS has updated guidance on the Public Health and Social Services Emergency Fund (PHSSEF)

  • Who: Grants for hospitals and providers based on Medicare revenue
  • What: Reimburse for expenses and lost revenues of COVID-19
  • How: for providers with direct deposit set up with Medicare, funds will be automatically deposited into your bank account; for providers without direct deposit, CMS will require the providers to complete a registration.
  • Details on registration not yet released
  • Do not have to pay back; grant
  • Important: healthcare providers should continue to quantify and monitor all COVID-10 expenses and retain copies of all relevant documents and reports, including records related to treatment of uninsured individuals for COVID-19. Future developments may arise for additional funds.

Additional info: AMA Article; Woodlands Online Article

Risk Adjustment for Medicare & Medicare Advantage Patients:

CMS just released guidance on risk adjustment for telemedicine visits. Providers and organizations that submit diagnoses for risk adjusted payment are now able to submit diagnoses for risk adjustment that are from telehealth visits.

Submission for these visits are allowed when they meet all criteria for risk adjustment:
-The visit is outpatient/professional service/inpatient
-A face to face encounter (this requirement is also met when using interactive audio/video that permits real-time interactive communication)

This is a huge step forward in allowing providers to utilize technology to reach patients and continue to see revenue for services provided remotely.

To view the CMS announcement, click here. Additional questions can be sent to RiskAdjustment@cms.hhs.gov by listing “Applicability of telehealth services for risk adjustment” in the subject line.

COVID Testing Sites

This is the most recent DOH compiled testing site list. Hawaii IPA has turned this into a working document and is updating it with pop- up sites as they arise. Please feel free to comment on this document if you have additional information so we can keep everyone up-to- date.

Patient Resources

  • Hawaii’s only statewide hotline partnering with the Department of Health. Provides community assistance finding food, shelter, elderly care, etc. Aloha United Way’s 211 Website
    • CALL 211 for Aloha United Ways COVID-19 Hotline
  • Queen’s Online Mental Health Wellness Group
    • Virtual educational sessions for patients to help them manage stress; Monday evenings and Wednesday Afternoons
  • Kokua Maui’s COVID-19 resource page
  • Planning Steps for Patients & Families During the COVID-19 Crisis
  • HMSA information sheet for patients who have lost insurance\
  • Maui COVID-19 Resource Page
  • McKenna Recovery Center, an intensive outpatient addiction treatment program, in light of covid-19 restrictions, is continuing evaluation and treatment services — virtually — with drug testing in person (for Oahu and Kauai; coordinated through an on island lab for all other islands).
    • For appointment, please call 808-246-0663 or email lani@mckennarecoverycenter.com. See our website for more details about our services: https://mckennarecoverycenter.com/ . Eventual return to office services include locations in Honolulu, Oahu and Lihue, Kauai locations.  Consent to telemedicine services and registration packet must be provided, with current insurance coverage or self-pay.  Virtual services require stable internet connection and a smart phone/tablet/computer with functioning camera and audio.
    • Insurances accepted: UHA, KAISER Preferred, HMSA, & HMAA. On Kauai, also accepted are HMSA Quest & AlohaCare Quest. Others potentially on a case-by-case basis.

COVID-19 Provider Office Resources

Re-opening Your Practice

Other Resources

Contacts

Stephanie Martinez- Maui Physician Liasion
Stephanie@hawaiiipa.com
Kyleigh Arakaki-Oahu Physician Liaison
kyleigh@hawaiiipa.com
Ashley Graham- Consultant, Value Based Programs
ashley@hawaiiipa.com
Julie Warech- Administrator
julie@hawaiiipa.com

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