--- title: Medical Billing Blog | ClaimCare | COVID-19 Medical Reimbursement description: COVID-19 Medical Reimbursement | ClaimCare's Medical Billing Blog, rated in the top 1% of all blogs on the web, is a great source for up to date information on medical billing. --- ![New claimcare logo banner](https://www.claimcare.net/hs-fs/hubfs/New%20claimcare%20logo%20banner.jpg?width=977&name=New%20claimcare%20logo%20banner.jpg) Search > Welcome to the ClaimCare Medical Billing Blog. We strive to provide content that improves the overall quality of medical billing efforts across the US. If you have any specific topics that you would like to see addressed in this medical billing blog please post the topic in the [Medical Billing Questions & Answers Forum](https://www.claimcare.net/medical-billing-resources/medical-billing-questions-forum/). If you have an article that you would like considered for publication in the medical billing blog then please email your article to [resources@claimcare.net](mailto:resources@claimcare.net). # MEDICAL BILLING BLOG ## [Medicare Payment for COVID-19 Vaccine Increases!](https://www.claimcare.net/medical-billing-blog/medicare-payment-for-covid-19-vaccine-increases) Posted by Carl Mays, ClaimCare President/CEO on Tue, Mar 16, 2021 @ 03:31 PM - [Tweet](https://twitter.com/share) **For COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies and other immunizers will be $40 per dose. ** **![BLOG-1](https://www.claimcare.net/hs-fs/hubfs/BLOG-1.jpg?width=380&name=BLOG-1.jpg)** This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines, and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished. This new and higher payment rate will support important actions taken by providers that are designed to increase the number of vaccines they can furnish each day, including establishing new or growing existing vaccination sites, conducting patient outreach and education, and hiring additional staff. At a time when vaccine supply is growing, Centers for Medicare & Medicaid Services (CMS) is supporting provider efforts to expand capacity and ensure that all Americans can be vaccinated against COVID-19 as soon as possible. CMS is updating the set of toolkits for providers, states, and insurers to help the health care system swiftly administer the vaccine with these new Medicare payment rates. These resources are designed to increase the number of providers that can administer the vaccine, ensure adequate payment for administering the vaccine to Medicare beneficiaries, and make it clear that no beneficiary, whether covered by private insurance, Medicare or Medicaid, should pay cost-sharing for the administration of the COVID-19 vaccine. **Coverage of COVID-19 Vaccines** As a condition of receiving free COVID-19 vaccines from the federal government, vaccine providers are prohibited from charging patients any amount for administration of the vaccine. To ensure broad and consistent coverage across programs and payers, the toolkits have specific information for several programs, including: **Medicare: **Beneficiaries with Medicare pay nothing for COVID-19 vaccines and there is no applicable copayment, coinsurance or deductible.** ** **Medicare Advantage (MA):** For calendar years 2020 and 2021, Medicare will pay providers directly for the COVID-19 vaccine (if they do not receive it for free) and its administration for beneficiaries enrolled in MA plans. MA plans are not responsible for paying providers to administer the vaccine to MA enrollees during this time. Like beneficiaries in Original Medicare, Medicare Advantage enrollees also pay no cost-sharing for COVID-19 vaccines. **Medicaid:** State Medicaid and CHIP agencies must provide vaccine administration with no cost sharing for nearly all beneficiaries during the public health emergency (PHE) and at least one year after it ends. Through the American Rescue Plan Act signed by President Biden on March 11, 2021, the COVID-19 vaccine administration will be fully federally funded. The law also provides an expansion of individuals eligible for vaccine administration coverage. There will be more information provided in upcoming updates to the Medicaid toolkit at [**Toolkit**](https://www.medicaid.gov/state-resource-center/downloads/covid-19-vaccine-toolkit.pdf)**.**  ** ** **Private Plans:** CMS, along with the Departments of Labor and Treasury, is requiring that most private health plans and issuers cover the COVID-19 vaccine and its administration, both in-network and out-of-network, with no cost- sharing during the public health emergency (PHE). Current regulations provide that out-of-network rates must be reasonable, as compared to prevailing market rates, and reference the Medicare reimbursement rates as a potential guideline for insurance companies. In light of CMS’s increased Medicare payment rates, CMS will expect commercial carriers to continue to ensure that their rates are reasonable in comparison to prevailing market rates.** ** **Uninsured:** For individuals who are uninsured, providers may submit claims for reimbursement for administering the COVID-19 vaccine to individuals without insurance through the Provider Relief Fund, administered by the Health Resources and Services Administration (HRSA). More information on Medicare payment for COVID-19 vaccine administration – including a list of billing codes, payment allowances and effective dates – is available at [**Vaccine Shot Payment**](https://www.cms.gov/medicare/covid-19/medicare-covid-19-vaccine-shot-payment). More information regarding the Centers for Disease Control and Prevention (CDC) COVID-19 Vaccination Program Provider Requirements, and how the COVID-19 vaccine is provided at 100% no-cost to recipients is available at [**Provider Support**](https://www.cdc.gov/vaccines/covid-19/vaccination-provider-support.html). Information on the COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured Program is available at [**Covid-19 Uninsured**](https://www.hrsa.gov/CovidUninsuredClaim).  To view the complete Centers for Medicare & Medicaid Services (CMS) announcement, click [Vaccine Payments](https://www.cms.gov/newsroom/press-releases/biden-harris-administration-increases-medicare-payment-life-saving-covid-19-vaccine#:~:text=This%20represents%20an%20increase%20from,19%20vaccines%20requiring%20two%20doses.).  To contact CMS Media Relations: (202) 690-6145 or [CMS Media Inquiries.](https://app.hubspot.com/blog/11609/edit-beta/43207438695/content) **![ClaimCare Blue web](https://www.claimcare.net/hs-fs/hubfs/ClaimCare%20Blue%20web.png?width=324&name=ClaimCare%20Blue%20web.png)** **A****bout ClaimCare** **®**                         ClaimCare has **30 years of medical billing experience**. We have an established **100% USA-Based** medical billing team that has been assembled through a thorough pre-employment screening. All personnel participate in on-going training and strong process management to ensure they deliver only the highest quality medical billing services to clients. ClaimCare has once again been named a “Top 10 Medical Billing and Coding Company.” The honor this time comes from *MD Tech Review*. The magazine’s [**Augmenting Medical Billing and Coding Operations**](https://www.mdtechreview.com/vendor/claimcare-augmenting-medical-billing-and-coding-operations-cid-36-mid-7.html) article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition.  ![](https://www.claimcare.net/hubfs/image-png-Mar-16-2021-04-46-00-05-PM.png) For more information, contact [**sales@claimcare.net**](mailto:sales@claimcare.net), or phone toll-free at (855) 376-7631, or visit the [**ClaimCare Medical Billing Company**](https://www.claimcare.net/) website. We can assist your practice and/or facility in numerous ways, including complete certification processing.   [**100% USA-Based HIPAA-Compliant Medical Billing Company**](https://www.claimcare.net/medical-billing-blog/10-tips-on-how-you-can-ensure-your-medical-billing-company-is-hipaa-compliant) ![new](https://www.claimcare.net/hs-fs/hubfs/new.jpg?width=233&name=new.jpg)   0 Comments [Click here to read/write comments](https://www.claimcare.net/medical-billing-blog/medicare-payment-for-covid-19-vaccine-increases#comments-listing) Tags: [medical billing](https://www.claimcare.net/medical-billing-blog/topic/medical-billing), [medical billing process](https://www.claimcare.net/medical-billing-blog/topic/medical-billing-process), [COVID-19 Medical Reimbursement](https://www.claimcare.net/medical-billing-blog/topic/covid-19-medical-reimbursement), [COVID-19](https://www.claimcare.net/medical-billing-blog/topic/covid-19), [COVID and the law](https://www.claimcare.net/medical-billing-blog/topic/covid-and-the-law) ## [CMS Seeks Faster COVID-19 Lab Results](https://www.claimcare.net/medical-billing-blog/cms-seeks-faster-covid-19-lab-results) Posted by Carl Mays, ClaimCare President/CEO on Fri, Oct 16, 2020 @ 01:03 PM - [Tweet](https://twitter.com/share) **CMS Seeks Faster COVID-19 Lab Results ** CMS is working to ensure that patients who test positive for the virus are alerted quickly so they can self-isolate and receive medical treatment. Thus, under President Trump’s leadership, the Centers for Medicare & Medicaid Services posted an October 15 announcement of new actions to pay for expedited COVID-19 test results. ![BLOG](https://www.claimcare.net/hs-fs/hubfs/BLOG.jpg?width=600&name=BLOG.jpg) Back on April 15, CMS Administrator Seema Verma [announced](https://www.cms.gov/newsroom/press-releases/cms-increases-medicare-payment-high-production-coronavirus-lab-tests-0), “CMS has made a critical move to ensure adequate reimbursement for advanced technology that can process a large volume of COVID-19 tests rapidly and accurately.” At that time, Medicare payment to laboratories for high throughput COVID-19 diagnostic tests was increased from approximately $51 to $100 per test. Now, to encourage labs to increase the rapidity in receiving results, beginning January 1, 2021, Medicare will pay $100 only to laboratories that complete high throughput COVID-19 diagnostic tests **within two calendar days of the specimen being collected**. Medicare will pay a rate of $75 to laboratories that take longer than two days to complete these tests, effective also on January 1, 2021. “As America continues to grapple with the COVID-19 pandemic, prompt testing turnaround times are more important than ever,” said CMS Administrator Seema Verma. This updated payment announcement “supports faster high throughput testing, which will allow patients and physicians to act quickly and decisively with respect to treatment decisions, physical isolation, and contact tracing. President Trump continues to lead the most robust testing effort anywhere in the world.” **Amended Administrative Ruling (CMS 2020-1-R2)** This amended ruling, effective January 1, 2021, lowers the base payment amount for COVID-19 diagnostic tests run on high-throughput technology from $100 to $75 in accordance with CMS’s assessment of the resources needed to perform those tests. Then, Medicare will make an additional $25 add-on payment to laboratories for a COVID-19 diagnostic tests run on high-throughput technology if the laboratory: **(1)** completes the test in two calendar days or less, and **(2)** completes the majority of their COVID-19 diagnostic tests that use high throughput technology in two calendar days or less for all of their patients *(not just their Medicare patients)* in the previous month. **HCPCS Code U0005** CMS established these requirements to support faster high throughput COVID-19 diagnostic testing and to ensure all patients *(not just Medicare patients*) benefit from faster testing. These actions will be implemented under the amended Administrative Ruling *(CMS-2020-1-R2)* and coding instructions for the $25 add-on payment *(HCPCS Code U0005)* released October 15. According to [CMS](https://www.cms.gov/newsroom/press-releases/cms-changes-medicare-payment-support-faster-covid-19-diagnostic-testing#:~:text=CMS%20previously%20took%20action%20in,%2451%20to%20%24100%20per%20test.&text=Also%20effective%20January%201%2C%202021,pay%20a%20rate%20of%20%2475.), “The new payment amounts effective January 1, 2021 ($100 and $75) reflect the resource costs laboratories face for completing COVID-19 diagnostics tests using high throughput technology in a timely fashion during the Public Health Emergency." **Impact on Laboratories** This CMS update may have an impact on laboratories’ **logistics** and/or **sample collections** beginning with dates of service from January 21, 2021, forward. Please note that the two-day clock starts when the sample is **COLLECTED**, not when it is received by the lab. It appears this updated policy is measured on a monthly basis. The two scenarios seem to be:    1. In the prior month, the lab **completes** the majority of ALL COVID-19 tests *(across all payers, not just Medicare)* in 2 days or less from sample collection, and the two codes are billed:         a. COVID-19 test (U0004), which will pay $75        b. Fast completion code (U0005), which will pay $25     2. In the prior month, the lab does not **complete** the majority of ALL COVID-19 tests *(across all payers, not just Medicare)* in 2 days or less from sample collection, and the one code is billed:         a. COVID-19 test (U0004), which will pay $75 **Questions Will Be Asked** Undoubtedly, laboratories will have questions regarding this updated policy, and I feel sure additional information will be coming from CMS to answer such questions as: 1. What does “majority” mean? Simple majority? Super majority?   1. Do both the test being billed AND the majority of tests from prior months need to be completed in two days or less? If you visit the CMS [source](https://www.cms.gov/newsroom/press-releases/cms-changes-medicare-payment-support-faster-covid-19-diagnostic-testing#:~:text=CMS%20previously%20took%20action%20in,%2451%20to%20%24100%20per%20test.&text=Also%20effective%20January%201%2C%202021,pay%20a%20rate%20of%20%2475.), the text is not clear on this point.   1. What if the issue is with the sample source and not with the lab when it comes to missing the two-day mark?  When ClaimCare uncovers more information regarding this updated policy, we will posting it via our blogs. **__________________________ ** **A****bout ClaimCare ®                        ** ClaimCare has **30 years of medical billing experience**. We have an established **100% USA-based** medical billing team that has been assembled through a thorough pre-employment screening. All personnel participate in on-going training and strong process management to ensure they deliver only the highest quality medical billing services to ClaimCare clients. ClaimCare has once again been named a “Top 10 Medical Billing and Coding Company.” The honor this time comes from *MD Tech Review*. ![image-png-1](https://www.claimcare.net/hs-fs/hubfs/image-png-1.png?width=120&name=image-png-1.png)The magazine’s [**Augmenting Medical Billing and Coding Operations**](https://www.mdtechreview.com/vendor/claimcare-augmenting-medical-billing-and-coding-operations-cid-36-mid-7.html) article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition. For more information, contact [sales@claimcare.net](mailto:sales@claimcare.net), or phone toll-free at (855) 376-7631, or visit the [**ClaimCare Medical Billing Company**](https://www.claimcare.net/) website. We can assist your practice and/or facility in numerous ways, including complete certification processing. **![image-png-2](https://www.claimcare.net/hs-fs/hubfs/image-png-2.png?width=148&name=image-png-2.png)** [**100% USA-Based HIPAA-Compliant Medical Billing Company**](https://www.claimcare.net/medical-billing-blog/10-tips-on-how-you-can-ensure-your-medical-billing-company-is-hipaa-compliant) 0 Comments [Click here to read/write comments](https://www.claimcare.net/medical-billing-blog/cms-seeks-faster-covid-19-lab-results#comments-listing) Tags: [Medicaid billing](https://www.claimcare.net/medical-billing-blog/topic/medicaid-billing), [COVID-19 Medical Reimbursement](https://www.claimcare.net/medical-billing-blog/topic/covid-19-medical-reimbursement), [COVID-19](https://www.claimcare.net/medical-billing-blog/topic/covid-19), [Medicare & Medicaid](https://www.claimcare.net/medical-billing-blog/topic/medicare-medicaid) ## [April 3, 2020 Update to Medicare Telemedicine Notification](https://www.claimcare.net/medical-billing-blog/april-3-2020-update-to-medicare-telemedicine-notification) Posted by Carl Mays, ClaimCare President/CEO on Fri, Apr 03, 2020 @ 06:29 PM - [Tweet](https://twitter.com/share) **April 3, 2020 Update to Medicare Telemedicine Notification** ![telehealthmedicare](https://www.claimcare.net/hs-fs/hubfs/telehealthmedicare.jpg?width=243&name=telehealthmedicare.jpg)At 2:45 this afternoon, [CMS](https://www.cms.gov/) notified all providers via Special Edition Message that CMS has made yet another change in the coding requirements for Telemedicine/Telehealth services. Pointed out below are the most critical changes, which pertain to place of service and modifier utilization. Here is the original [**April 1 Telemedicine Blog Post**](https://www.claimcare.net/medical-billing-blog/latest-telehealth-cms-update-provides-more-relief-for-providers-serving-patients-through-telemedicine?_ga=2.246483910.312976129.1585951122-1010972423.1585951122)  that contains the earlier CMS information to which we are now referring. Comparing the April 1 blog to this updated blog will make things less confusing to you.  **04-03-20 Revised Special Edition Telemedicine Message from [CMS](https://www.cms.gov/)** Building on prior action to expand reimbursement for telehealth services to Medicare beneficiaries, CMS will now allow for more than **80 additional services to be furnished via telehealth**. We will notify you when those services are clearly identified. For professional claims for **all telehealth** services with dates of services on or after March 1, 2020, and for the duration of the Public Health Emergency (PHE), telehealth claims need to be billed with: ![checklist](https://www.claimcare.net/hs-fs/hubfs/checklist.jpg?width=131&name=checklist.jpg) - Place of Service (POS) equal to what it would have been had the service been furnished in-person. This means you no longer use the 02 Place of Service. - Modifier 95, indicating that the service rendered was actually performed via telehealth. - As a reminder, CMS is **not** requiring the CR modifier on telehealth services. For telemedicine claims already billed with the “02 Place of Service,” medical billers actively monitoring these claims should show them as having been received and in process.  So, it appears this updated change will only impact claims from today forward. Your medical biller should notify you if they find any problems with older or new telemedicine claims.  [**ClaimCare**](https://www.claimcare.net/) remains on top of all things that impact practices and will continue to monitor these updates.  You may have numerous resources sending information to you. Make sure your medical biller vets every piece of information that is sent to you to ensure its validity.   We certainly hope you and your staff are staying safe and healthy during this crisis. We encourage you to share with everyone, staff and patients alike, that they can keep updated on the news and recommendations on the government’s [**Coronavirus.com**](https://www.coronavirus.gov/) website**.** ** ** **About ClaimCare** [**ClaimCare**](https://www.claimcare.net/?_ga=2.247025222.312976129.1585951122-1010972423.1585951122) is a 100% USA-based [**HIPAA-Compliant Medical Billing Company**](https://www.claimcare.net/medical-billing-blog/10-tips-on-how-you-can-ensure-your-medical-billing-company-is-hipaa-compliant?_ga=2.246483910.312976129.1585951122-1010972423.1585951122) ClaimCare has once again been named a **“Top 10 Medical Billing and Coding Company.”** The honor this time comes from ***MD Tech Review***. The magazine’s [**Augmenting Medical Billing and Coding Operations**](https://www.mdtechreview.com/vendor/claimcare-augmenting-medical-billing-and-coding-operations-cid-36-mid-7.html) article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition. For additional information, contact [sales@claimcare.net](mailto:sales@claimcare.net), or phone toll-free (855) 376-7631, or visit the [**ClaimCare Medical Billing**](https://www.claimcare.net/medical-billing-blog/topic/medical-billing?_ga=2.247025222.312976129.1585951122-1010972423.1585951122) website. We can assist your practice and/or facility in numerous ways. 0 Comments [Click here to read/write comments](https://www.claimcare.net/medical-billing-blog/april-3-2020-update-to-medicare-telemedicine-notification#comments-listing) Tags: [medical billing coding](https://www.claimcare.net/medical-billing-blog/topic/medical-billing-coding), [COVID-19 Medical Reimbursement](https://www.claimcare.net/medical-billing-blog/topic/covid-19-medical-reimbursement), [Medicare Billing](https://www.claimcare.net/medical-billing-blog/topic/medicare-billing), [Telehealth](https://www.claimcare.net/medical-billing-blog/topic/telehealth), [CMS Update](https://www.claimcare.net/medical-billing-blog/topic/cms-update), [Practice Cash Flow](https://www.claimcare.net/medical-billing-blog/topic/practice-cash-flow) ## [Practice Cashflow Update April 1, 2020](https://www.claimcare.net/medical-billing-blog/practice-cashflow-update-april-1-2020) Posted by Carl Mays, ClaimCare President/CEO on Thu, Apr 02, 2020 @ 08:00 AM - [Tweet](https://twitter.com/share) **Four Options to Quickly Boost Your Practice’s Cash on Hand Balance** ![CashFlow](https://www.claimcare.net/hs-fs/hubfs/CashFlow.jpg?width=242&name=CashFlow.jpg) As patient volumes have fallen, many practices are worried about keeping their doors open through this national COVID-19 crisis. With that in mind, the goal of this update is to outline four options at your disposal to quickly increase your available cash balances. These have all been made available or made easier to pursue by recent government changes in reaction to the economic turmoil being caused by COVID-19 and the related “shelter in place” orders around the country. These are listed in the order from fastest to slowest in terms of increasing your available cash on hand.    - **Apply for Medicare’s Accelerated Payment and Advance Program** - **Apply for the Paycheck Protection Program as soon as it is open for applications** - **Aggressively pursue telemedicine** - **Apply for a Small Business Administration (SBA) Economic Injury Disaster Loan **                            **Details and key links for these options** **1.  Apply for Medicare’s Accelerated Payment and Advance Program.**       This program will advance you up to three months of your normal monthly Medicare payments.             Key elements of the program: ![CMS_expands_financial_relief_for_Medicare_Providers_pic___3.31.20du___virus_4970581_1920___Pixabay.5e835a4f8b198](https://www.claimcare.net/hs-fs/hubfs/CMS_expands_financial_relief_for_Medicare_Providers_pic___3.31.20du___virus_4970581_1920___Pixabay.5e835a4f8b198.png?width=273&name=CMS_expands_financial_relief_for_Medicare_Providers_pic___3.31.20du___virus_4970581_1920___Pixabay.5e835a4f8b198.png) **2.  Apply for the Paycheck Protection Program **       Key elements of the program: - It should be live for applications by Friday, April 3rd. - The money should be in your account in two weeks or less. -  It will be administered by banks and not the SBA. - - You can receive a loan of up to 2.5 times your monthly payroll. - No payments are owed for the first 6 months, and no payments will be owed at all if you meet the guidelines for full loan forgiveness. - For the loan to be forgiven you need to use it within the eight weeks after the funds are received to pay for employee salaries, rent, utilities and other similar expenses. You also need to maintain your payroll and not significantly reduce it through layoffs or wage reductions. - Here is a link to more information about the program: [SBA Paycheck Protection Program](https://www.sba.gov/funding-programs/loans/paycheck-protection-program-ppp). **3.  Aggressively pursue telemedicine.** We have released multiple updates on this. The bottom line is that the reimbursements have increased, while the amount of required paperwork and other requirements have decreased; and the scope of what can be done with telemedicine has expanded. Please follow these links to see our latest updates on the ClaimCare Blog: - [How to Use Telemedicine to Keep Collections Flowing During the COVID-19 Crisis](https://www.claimcare.net/medical-billing-blog/keeping-your-practice-revenue-flowing-during-the-coronavirus?_ga=2.254148936.1966740717.1585782181-755473376.1585782181) - [Latest Telehealth Changes Give More Relief to Providers](https://www.claimcare.net/medical-billing-blog/latest-telehealth-cms-update-provides-more-relief-for-providers-serving-patients-through-telemedicine?_ga=2.254148936.1966740717.1585782181-755473376.1585782181).  **4.  Apply for a Small Business Administration Economic Injury Disaster Loan.** These loans are available because a state of emergency has been declared. These loans will take longer to result in cash on hand than the first three options outlined, but they also allow for a loan amount of up to $2 million. These are different than normal SBA loans and the lending rules are more lenient.      Key elements of the program:  ![SBA-Loan-1030x687](https://www.claimcare.net/hs-fs/hubfs/SBA-Loan-1030x687.jpg?width=198&name=SBA-Loan-1030x687.jpg) - These loans are administered by the SBA. - - You can borrow up to $2 million. - You can receive an almost immediate advance of $10,000. - All businesses in all states are now eligible for these loans. - The loan proceeds can be used for expenses that cannot be paid because of the COVID-19 economic disaster. - The interest rate will be 3.75%. - You will have up to 30 years to repay the loan. - None of this loan is forgivable. - Here is a link to the SBA [Economic Disaster Loan Application](https://covid19relief.sba.gov/#/). As you can see, you have four great options to quickly improve your current cash position and help sustain you through this economic crisis. Rest assured that ClaimCare, with our fully HIPPA-compliant 100% USA-based  work from home team, is focusing on every lever at our disposal to quickly bring money in from our clients' existing and new claims. We encourage you to reach out to your practice’s banker to get more information about the loans outlined above. Please let [**ClaimCare**](https://www.mdtechreview.com/vendor/claimcare-augmenting-medical-billing-and-coding-operations-cid-36-mid-7.html) know if you are in need of a professional medical billing company to become your partner and help you during this COVID-19 crisis - and beyond. Our mission statement is ***"To collect the maximum revenue for your practice as fast as possible while helping to alleviate costs and hassle for your organization" ***   **About ClaimCare** [**ClaimCare**](https://www.claimcare.net/) is a 100% USA-based [**HIPAA-Compliant Medical Billing Company**](https://www.claimcare.net/medical-billing-blog/10-tips-on-how-you-can-ensure-your-medical-billing-company-is-hipaa-compliant) ClaimCare has once again been named a **“Top 10 Medical Billing and Coding Company.”**  The honor this time comes from ***MD Tech Review***.  The magazine’s [**Augmenting Medical Billing and Coding Operations**](https://www.mdtechreview.com/vendor/claimcare-augmenting-medical-billing-and-coding-operations-cid-36-mid-7.html) article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition. For additional information, contact [sales@claimcare.net](mailto:sales@claimcare.net), or phone toll-free (855) 376-7631, or visit the [**ClaimCare Medical Billing**](https://www.claimcare.net/medical-billing-blog/topic/medical-billing) website.  We can assist your practice and/or facility in numerous ways. 0 Comments [Click here to read/write comments](https://www.claimcare.net/medical-billing-blog/practice-cashflow-update-april-1-2020#comments-listing) Tags: [Physician Reimbursement](https://www.claimcare.net/medical-billing-blog/topic/physician-reimbursement), [COVID-19 Medical Reimbursement](https://www.claimcare.net/medical-billing-blog/topic/covid-19-medical-reimbursement), [telemedicine](https://www.claimcare.net/medical-billing-blog/topic/telemedicine), [SBA Loan](https://www.claimcare.net/medical-billing-blog/topic/sba-loan), [Practice Cash Flow](https://www.claimcare.net/medical-billing-blog/topic/practice-cash-flow) ## [Accelerated Payment and Advance for Providers](https://www.claimcare.net/medical-billing-blog/accelerated-payment-and-advance-for-providers) Posted by Carl Mays, ClaimCare President/CEO on Tue, Mar 31, 2020 @ 08:03 PM - [Tweet](https://twitter.com/share) **Accelerated Payment and Advance for Providers:** **How to get it and what it means for your practice![iStock_CashFlow2](https://www.claimcare.net/hs-fs/hubfs/iStock_CashFlow2.jpg?width=257&name=iStock_CashFlow2.jpg)** CMS has notified providers about the Accelerated Payment and Advance program available to Part B providers. This is a portion of the legislative [**CARES Act (P.L. 116-136)**](https://www.healthlawdiagnosis.com/2020/03/cares-act-provides-vital-financial-support-for-health-care-providers-on-covid-19-front-lines/).  Each Medicare Administrative Contractor (MAC) is required under this regulation to consider advancing payments at the request of a provider.  As we will explain below, this is **NOT** a cash influx without consequences. It is **NOT** free money. This advance can represent 100% of the amount typically paid to a provider in a 3-month period.   However, if you want to, you can request less than the                                                                   CMS calculated amount. ** ** [**ClaimCare**](https://www.claimcare.net/medical-billing-blog/keeping-your-practice-revenue-flowing-during-the-coronavirus?utm_source=hs_email&utm_medium=email&utm_content=85372641&_hsenc=p2ANqtz--82Sei_OdtTkkkp3Pb8K5hBdEEFjkDNpFu0jtf9rq-BlTnqW3Ykg0ROxr8HDnJST4hPL9guRggC10xhpH0kZiQ2IQy-g&_hsmi=85372641&_ga=2.147167860.293890081.1585698310-798499019.1585698310) advises you to be cautious when requesting this advance.  We completely understand that numerous providers and practices have been hurt by this horrific COVID-19 Pandemic.  However, we encourage you to look at what this would mean for your practice on down the road.  ![increase-cash-flow-medical-practice](https://www.claimcare.net/hs-fs/hubfs/increase-cash-flow-medical-practice.png?width=249&name=increase-cash-flow-medical-practice.png)The amount of money received is not the issue. The issue is that you must carefully consider how the advance will be recouped and reconciled beginning 120 days after you have received it. It is still in flux exactly over what timeframe MAC will reclaim the advance through recoupments. MAC may take a little from every payment over a large number of months, or they may take a lot back from every payment over a shorter timeframe. It appears NOVITAS will be recouping a small amount over many months. However, no matter the timeframe in which the money is recouped, ultimately your future payments will be reduced until the full amount of the advance is paid. After you receive an advance through this program, you will continue to be paid as usual for your claims submitted in the normal course of business for the next 120 days.  However, after 120 days following the advance, **ANY** Medicare claims submitted for payment will be processed against the advance.  This means that after 120 days you will **NOT** receive full payment for claims submitted to Medicare until your advance is paid in full. ** **[**ClaimCare**](https://www.claimcare.net/medical-billing-blog/keeping-your-practice-revenue-flowing-during-the-coronavirus?utm_source=hs_email&utm_medium=email&utm_content=85372641&_hsenc=p2ANqtz--82Sei_OdtTkkkp3Pb8K5hBdEEFjkDNpFu0jtf9rq-BlTnqW3Ykg0ROxr8HDnJST4hPL9guRggC10xhpH0kZiQ2IQy-g&_hsmi=85372641&_ga=2.147167860.293890081.1585698310-798499019.1585698310) is not suggesting that you do not pursue the advance. We are only saying that if you do accept it, do so with a full appreciation for the impact it will have on your monthly collections in four months. All providers are struggling with trying to provide continuity of care by using [**telemedicine and videoconferencing**](https://www.claimcare.net/medical-billing-blog/keeping-your-practice-revenue-flowing-during-the-coronavirus?utm_source=hs_email&utm_medium=email&utm_content=85372641&_hsenc=p2ANqtz--82Sei_OdtTkkkp3Pb8K5hBdEEFjkDNpFu0jtf9rq-BlTnqW3Ykg0ROxr8HDnJST4hPL9guRggC10xhpH0kZiQ2IQy-g&_hsmi=85372641&_ga=2.147167860.293890081.1585698310-798499019.1585698310). We understand that if your schedules are not full, it is difficult to pay the bills and keep the doors open. If you need these funds, please be sure and submit the appropriate form as quickly as possible to your regional MAC. The forms have either been sent to your primary Medicare contact – OR – you can find them on the MAC website for your region. You should receive the accelerated payment advance in 7 days after your appropriately submitted form is received. This accelerated payment opportunity is only available if the nation us under a National Emergency.  Once this designation is over, the advance will not be available to providers.   **To qualify, you must meet the following requirements:   ** - Have billed Medicare for claims within 180 days of the signature on the form - Not be in bankruptcy - Not under medical review or investigation - Cannot have any outstanding Medicare overpayments After 120 days from the date you receive the payment, you will have 210 days to repay the advance, which will be offset against claims submitted.  If you do not submit a sufficient volume of claims in that 210-day period to replay the advance, then you will be expected to make a payment directly to Medicare for the difference. We certainly hope you and your staff are staying safe and healthy during this crisis. We encourage you to share with everyone, staff and patients, that they can keep updated on the news and recommendations on the government’s [**Coronavirus.com**](https://www.coronavirus.gov/) website**.** ** ** **About ClaimCare** [ClaimCare Medical Billing Company](https://www.claimcare.net/?_ga=2.193461870.293890081.1585698310-798499019.1585698310) is a 100% USA-based [**HIPAA-Compliant Medical Billing Company**](https://www.claimcare.net/medical-billing-blog/10-tips-on-how-you-can-ensure-your-medical-billing-company-is-hipaa-compliant?_ga=2.193461870.293890081.1585698310-798499019.1585698310) ClaimCare has once again been named a **“Top 10 Medical Billing and Coding Company.”** The honor this time comes from ***MD Tech Review***. The magazine’s [**Augmenting Medical Billing and Coding Operations**](https://www.mdtechreview.com/vendor/claimcare-augmenting-medical-billing-and-coding-operations-cid-36-mid-7.html) article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition. For additional information, contact [sales@claimcare.net](mailto:sales@claimcare.net), or phone toll-free (855) 376-7631, or visit the [ClaimCare Medical Billing](https://www.claimcare.net/medical-billing-blog/topic/medical-billing) website. We can assist your practice and/or facility in numerous ways. 0 Comments [Click here to read/write comments](https://www.claimcare.net/medical-billing-blog/accelerated-payment-and-advance-for-providers#comments-listing) Tags: [medical billing education](https://www.claimcare.net/medical-billing-blog/topic/medical-billing-education), [medical billing resources](https://www.claimcare.net/medical-billing-blog/topic/medical-billing-resources), [COVID-19 Medical Reimbursement](https://www.claimcare.net/medical-billing-blog/topic/covid-19-medical-reimbursement), [Medicare Billing](https://www.claimcare.net/medical-billing-blog/topic/medicare-billing) [All Posts](https://www.claimcare.net/medical-billing-blog/all) ### Subscribe by Email ### Most Popular ### Browse the Medical Billing Blog by Tag - [medical billing (34)](https://www.claimcare.net/medical-billing-blog/topic/medical-billing) - [medical billing services (32)](https://www.claimcare.net/medical-billing-blog/topic/medical-billing-services) - 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