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What if a provider submitted a claim to the HRSA COVID-19 Uninsured Program and the patient is actually underinsured, or vice versa?

What if a provider submitted a claim to the HRSA COVID-19 Uninsured Program and the patient is actually underinsured, or vice versa?

If a claim was submitted to the HRSA COVID-19 Uninsured Program and the patient was actually insured, the provider should receive a notice that the claim was not eligible for reimbursement.

Prior to submitting a claim to the Coverage Assistance Fund, the provider should submit a claim for vaccine administration to the individual’s health insurance plan for payment.  The provider can submit the claims to the HRSA COVID-19 Coverage Assistance Fund for claims for COVID-19 vaccine administration provided to individuals who have health insurance, but whose health plan either does not include COVID-19 vaccination as a covered benefit or covers COVID-19 vaccine administration but with cost-sharing. Only those COVID-19 vaccine administration claims denied or not fully paid by a patient’s health insurance plan, including those insurance plans with patient co-pays for vaccine administration, deductibles for vaccine administration, and co-insurance related to the Covid-19 vaccination, are eligible for reimbursement.

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