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Elizabeth M. Whitehorn, Director

Provider Notice Issued 12/22/2022

Date:   December 22, 2022

To:       All Medical Assistance Program Providers      

Re:      COVID-19 Limited Treatment Coverage for Monoclonal Antibody Administration for the Uninsured Population – Professional Claim Submittal

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This notice is a follow-up to the October 6, 2022, provider notice and confirms practitioners may now submit professional claims for monoclonal antibody treatment for a specific subset of the uninsured population.

The October 6, 2022, provider notice outlined the steps to verify the uninsured who are eligible for monoclonal antibody treatment:

  1. Check the MEDI system to verify if the person has an existing Recipient Identification Number (RIN) assigned with "COVID 19 Testing Only" eligibility for the date of service.
  2. If a RIN is found, the "Special Information" under the "COVID-19 Testing" eligibility in MEDI will show "Title XIX". 

The notice requested providers hold professional claims for uninsured customers eligible for monoclonal antibody administration until further notification that HFS claims processing updates have been completed. Those updates now have been finalized. If a provider identifies an existing recipient identification number (RIN) for an eligible uninsured customer, the provider must bill a claim to the Department of Healthcare and Family Services (HFS) through the provider's usual claim submittal process outside the HFS Uninsured Portal. 


The HFS Uninsured Portal currently remains unavailable. HFS will provide further updates regarding the status of the portal. 

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5564. 

 

Kelly Cunningham, Administrator

Division of Medical Programs