Pronto Self Pay Discovery for COVID-19 HRSA Attestation

Prior to billing HRSA for COVID-19 testing and treatment, providers must attest that to their best of their knowledge the patient does not have insurance.

From HRSA's FAQs for COVID-19 Claims Reimbursement of the Uninsured:

For claims for COVID-19 Testing and Testing-Related Items and Services, a patient is considered uninsured if the patient does not have coverage through an individual, or employer-sponsored plan, a federal healthcare program, or the Federal Employees Health Benefits Program at the time the services were rendered. For claims for treatment for positive cases of COVID-19, a patient is considered uninsured if the patient did not have any health care coverage at the time the services were rendered.

Providers must verify and attest that to the best of the provider's knowledge at the time of claim submission, the patient was uninsured at the time the services were provided. For claims for COVID-19 testing and testing-related items and services, this means that the patient did not have coverage through an individual, or employer-sponsored, a federal healthcare program, or the Federal Employees Health Benefits Program. For claims for treatment of positive cases of COVID-19, this means that the patient did not have any health care coverage. Providers may submit a claim for uninsured individuals before Medicaid eligibility determination is complete. However, if the provider learns that the individual is retroactively enrolled in Medicaid as of the date of service, the provider must return the payment to HRSA.

Source: hrsa.gov

Pronto Self Pay Discovery determines if patients have other Medicaid, Medicare or Commercial coverage and ensures compliance with HRSA guidelines quickly and at a low cost.


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How Pronto Self Pay Discovery works

Providers send a file with account information to Pronto for processing via SFTP. Pronto will process the file and return results formatted in CSV or Excel.


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