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.

PPE Resources Available

Masks, Sanitizers, Gloves

  • Wilson Care Group has set up alohamask.com, a Honolulu-based provider of non-medical PPE for Hawaii residents and businesses. They currently have:
    • Face Masks (KN95, 3-ply dispoable & fashion)
    • Face Shields
    • Disposable Gloves
    • Infrared Thermometers
    • Hand Sanitizer
    • Other products
  • Supplies available via PAC/RIM, discounted if identify yourself as a HIPA member when you place the order; 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
    • Other supplies: liquid sanitizer, gloves, surface disinfectants etc. via price list and recently updated flyer
    • Newly added item: face shields, one pack of 5 for $37.50. Click here to view the manual
  • The Legislature is expected to pass SB126 for PPE and put in place a system to order PPE. Will post updates as they come.

‘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 Fit Test & Sterilization

Fit tests/train the trainer: please email and convey numbers needed to train, location, if you have masks for training to: hiN95fit@gmail.com

FREE Battell mask sterilization: Medical care providers/first responders are able to enroll online by visiting www.battelle.org/decon

Telemedicine Resources

HIPA and Pacific Rim Basin Collaborative Telemedicine Webinars

Please click here to view all webinar recordings, slides, and resources for the webinars below.

6/17/20: Cost Share, Technology, and Reopening

5/27/20: Telehealth Coding

5/13/20: Telehealth 101 for Independent Physicians

COVID Cost Share Grid

Insurance plans are updating their waivers related to telemedicine coverage and patient cost share (copays/coinsurance).
Click here to view by payer on when these waivers run out, so that you can start to collect copays in your office again.
 
This is a live document, we will be updating it as payer policies change. We will also update here if/when CMS changes the 1135 waiver that allows non-HIPAA complaint platforms for telemedicine & allows reimbursement of telemedicine as a face-to-face encounter. CMS will be required to give 60 days’ notice before terming this waiver.
 

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.

Risk Adjustment for Medicare/Med Advantage Patients:

Providers and organizations that submit diagnoses for risk adjusted payment are 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.

*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

We have updated the below to include only active websites being updated by payers instead of stagnant documents. To see more on per payer guidance and updates please see the reference section of our Coding and Reimbursement Telemedicine Guide, being regularly updated.

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.

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

  • Temporary Public Assistance: Childcare, MedQuest, & Snap Support
  • Free Clinic for Unemployed/Uninsured due to COVID-19
    • Lt. Governor Josh Green and Dr. James Ireland, a Big Island
      community physician, are partnering to open a FREE medical clinic
      on Oahu. Its purpose is to help those who do not qualify for
      Medicaid and are low-income residents. The clinic will primarily focus on patients with chronic health conditions such as; hypertension, diabetes, nephrology problems, asthma, and COPD.
      Open June 1st through August 31st
      Hours of Operation: 9AM-4PM (Closed 12-1PM)
      Location: Kalihi Medical Building, 2055 North King Street, Suite 101,Honolulu
      To view Hawaii News Now Story: click here.
      If you are a health care provider and would like to volunteer, or a
      patient who needs to set up an appointment, please email:
      alohafreeclinic@gmail.com
  • 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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