04.02.20

Provider Initiative to Help Ease Financial and Administrative Stress During Coronavirus Pandemic

Source: Humana

Humana announced a series of actions designed to help provide financial and administrative relief for the health care provider community facing the COVID-19 pandemic.

First, Humana is implementing simplified and expedited claims processing in order to get reimbursement payments to providers as quickly as possible and help ease their financial concerns.

In addition, the company is expanding its policy of suspending prior authorization and referral requirements, instead requesting notification within 24 hours of inpatient (acute and post-acute) and outpatient care. This is applicable for:

  • All providers (regardless of network affiliation) for patient care related to COVID-19
  • In-network providers, for patient care not directly related to COVID-19*

These policies are applicable for covered plan benefits under individual and group Humana Medicare Advantage, Medicaid, and commercial employer-sponsored plans. The company is taking these actions in response to the pandemic, and will reassess as circumstances change.

Providers may visit https://www.humana.com/provider/coronavirus for more information.

“Humana is committed to supporting clinicians by providing practical solutions to help alleviate administrative burden and boost system viability during these extraordinary times,” William Shrank, MD, MSHS, Humana’s Chief Medical Officer, said in a company news release. “This initiative is of utmost importance to us in enabling health systems and the physician community to devote as much time and resources as possible to frontline patient care.”

The company’s announcement is part of an ongoing effort to provide resources and assistance to providers and members affected by COVID-19. Humana also is:

  • Waiving the member responsibility for copays, deductibles or coinsurance associated with COVID-19 testing, including related visit costs in a range of clinical settings such as a physician’s office, urgent care center or emergency department. **
  • Waiving member responsibility for copays, deductibles or coinsurance related to the covered treatment of COVID-19, including inpatient hospital admissions. **
  • Waiving member responsibility for copays, deductibles or coinsurance for all telehealth services delivered by participating/in-network providers and accepting audio-only/telephone and audio-video visits for reimbursement.
  • Allowing early prescription refills, so members can prepare for extended supply needs – an extra 30- or 90-day supply as appropriate
  • Providing a member-support line with specially trained call center employees to help support members with specific coronavirus questions and concerns, including live assistance with telehealth.
  • Lifting administrative requirements for members infected with coronavirus and for all patients in settings where capacity is stretched by the needs of those infected by coronavirus. The change allows for unencumbered movement from inpatient hospitals to safe, medically appropriate post-acute care settings, including home health, long-term acute care hospitals, skilled nursing facilities, etc.

* Exceptions include transplant and genetic procedures, as well as pharmacy coverage.

** For commercial employer-sponsored plans, includes fully insured and select self-funded plans.

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