Key highlights

As a health solutions organization that operates health plans, care delivery, research and education, we are in a unique position to provide support and stability to all of our customers during this crisis. Our core functions and tools remain fully operational and effective without disruption. We’re here to assist our members and patients through online services, claims processing, phone consultations, telemedicine, and by providing referrals to a nearby provider. Below outlines the key highlights of our expanded medical and dental coverage.
 

Medical coverage:

HealthPartners waives cost-sharing.
HealthPartners, will waive member cost-sharing for all fully insured commercial, Medicare and Medicaid members for in network COVID-19 related treatment through December 31, 2020. We are actively working with our self-insured clients to make this option available for their employees and dependents.

• Waiving early medication refill limits on 30-day prescription authorizations and encouraging 90-day mail order benefits
• Allowing retail pharmacists at point of sale to override claim that is rejecting for ‘refill too soon'
• Removing prior authorization for COVID-19 diagnostic service
• Coverage of medically necessary tests
• Providing coverage for online care eligible to all HealthPartners members
• Expanding access to telehealth

HealthPartners recommends that providers submit the modifier CS on office visits associated with COVID-19 lab testing to aid in identifying COVID-19-related-claims.

Dental coverage:

• A message to our dental community
• Tips for triaging dental patients
• Covid19 update for our dental partners
• Teledentistry Communication
• Dental PPE Provider communication
• Policy-Billing for Infection Control-PPE

Impacted products related to this information include:

• Individual
• Fully insured commercial
• Self-Insured commercial 
• Medicare Advantage Members

Telehealth/Telemedicine Services - Policy updated 05-15-2020

HealthPartners commercial products coverage

As your partner, protecting the health and safety of our members, patients, and providers is our top priority. We want to ensure our members and patients have access to the care, resources, and support they need during this trying time. That’s why we’ve broadened our telemedicine policy to help people address their health concerns without needing to leave their home, reducing their risk of exposure to the virus. Many routine issues can be assessed virtually without an in-person visit to a provider, whether it be assessment of a new condition or adjustments in treatment for an existing condition.

Temporary Telemedicine policy during the COVID-19 national health emergency

To encourage broader use of virtual services during the COVID-19 Public Health Emergency, HealthPartners has revised policies for the coverage of telephone and video visits and updated reimbursement for said services. These revised policies are intended to add clarity of coverage and to add additional eligible services for telehealth as follows:

• Physical Therapy, Occupational Therapy, and Speech Therapy services have been added.
• In accordance with actions taken by CMS, HealthPartners will allow non-HIPAA compliant audio-visual applications, such as Facetime and Skype, to be used for telehealth services.
• HealthPartners will waive the policy requirement of a visual component for telehealth, allowing for telehealth to be provided over the telephone.
• HealthPartners is temporarily suspending our policy requirement of telehealth and telephone services being provided only to established patients so that during the duration of the National Health Emergency related to COVID-19, telehealth and telephone visits can also be provided to new patients.
• Behavioral Health visits are described.
• In order to reduce the risk of spreading COVID-19, both the practitioner and the member can be located at their homes for telehealth and telephone visits.
• Please note that member responsibility will apply to telemedicine visits, E-visits and scheduled telephone visits per the member’s certificate of coverage.
• We will continue to evaluate our telemedicine policy for updates as the National Emergency Continues.

COVID-19 Diagnostic Testing and Specimen Collection Reimbursement

Unless specifically agreed otherwise, HealthPartners reimbursement rates for contracted and non-contracted providers, facilities and reference labs are based upon the Centers for Medicare and Medicaid Services (“CMS”) rates for COVID-19 testing. As new codes are developed by CMS, HealthPartners will add those codes and the associated rates to its fee schedule(s). The current reimbursement rates are follows*:

* Inclusion of the rates in the table above does not guarantee payment which is determined by the applicable certificate of coverage and your Agreement with HEALTHPARTNERS, INC.

* COVID-19 diagnostic testing, antibody testing and specimen collection codes are included in the reimbursement rates for inpatient services and will not be paid in addition to the DRG, per diem, or case rate payment.

** To be determined once CMS releases its rate.