Date: February 15, 2023
To: All Medical Assistance Program Providers
Re: HFS COVID Portal for the Uninsured—Resuming Availability for Recipient Identification Number Generation Effective February 1, 2023
This notice updates providers regarding the COVID portal. This online portal was designed to generate recipient identification numbers (RINs) and allow claim submission of COVID-19 testing, testing related services, and vaccine administration for the uninsured population.
By provider notices dated August 2, 2022, October 6, 2022, and December 16, 2022, the Department of Healthcare and Family Services (HFS) has kept providers informed of the status of the COVID portal. The portal was taken offline, as it had been overloaded with repeat requests for RINs for persons already assigned a RIN. The COVID portal was re-opened as of February 1, 2023, for the RIN generation function only. Providers were notified previously that at the time the portal was re-opened, the claim generation utility would no longer be available.
Providers are required to verify eligibility in order to identify already-existing RINs for customers. If providers identify both an existing full-coverage Medicaid RIN and a "COVID-19 Testing Only" RIN for a customer, the full-coverage Medicaid RIN should be used. Providers then must rebill any unpaid claims through normal claim submission methods outside the portal. This includes any claims that previously processed through the portal and rejected. Exception: At this time, hospitals are excluded from the instructions in this notice. HFS will update hospitals with specific billing instructions in a later release.
For Uninsured Persons Who Do Not Already Have a RIN Assigned:
If providers have determined through eligibility verification the patient does not already have an existing RIN, a RIN should be requested through the portal. Only one record with the earliest date of service for which the provider needs to submit a claim should be uploaded to the portal. Once a RIN is assigned to the individual the provider may bill all applicable service dates on the claim(s) submitted outside the portal. To request a RIN through the portal, providers are required to submit the following data elements with the portal's re-opening. Please reference the detailed file requirements linked below for other required fields. Please Note: The SSN must be the patient's true SSN. Do not populate this field with anything other than the patient's actual SSN.
- Birth Date
- Social Security Number (SSN)
For Uninsured Persons Who Do Not Have a RIN Assigned and Do Not Have a Social Security Number (SSN):
An SSN is now a required element for requesting a RIN. It is a key identifier in terms of HFS examining multiple RINS assigned through the portal for the same person. Providers need to obtain SSNs from their patients who have them.
Further guidance for patients who have no SSN, or for which providers have aged claims and are unable to obtain a SSN, will be addressed in a later release.
For Uninsured Persons Who Do Already Have a RIN Assigned:
Providers should bill any unpaid or previously rejected claims to HFS through the provider's usual claim submittal process. Please note that usual ordering/referring requirements will apply to these claims.
The Department will systematically lift the timely filing edits on claims received for the uninsured population, regardless of submittal method. Providers will not need to request a manual time override via claim attachment.
As a reminder, all claims for the uninsured population must contain a diagnosis code indicating the patient encounter was for the purposes of COVID testing, COVID vaccine administration, and/or COVID medication treatment. Paid claims with no COVID or COVID-related diagnosis code are subject to post-payment review and recoupment.
The following documents are linked below:
- Detailed file requirements
- A sample Excel file layout
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565.
Kelly Cunningham, Administrator
Division of Medical Programs