Back in mid-March, Health Resources & Services Administration (HRSA) funding ended for COVID-19 treatment and testing for the uninsured. Many Urgent Care centers are reporting they have been unable to get reimbursement for claims submitted months, and in some cases, years prior to the deadline.
In a recent survey conducted by the Urgent Care Association, nearly 30 organizations claimed to each having over 500 unreimbursed claims submitted to the HRSA COVID-19 Uninsured Fund. A conversation surrounding this topic formed in an internal UCA forum. Among those members was Kathy Sanchez, Co-owner of Medi-Station Urgent Care in Miami Shores, Florida.
“Everybody’s having problems,” Sanchez said. “And there’s no way to get in touch with anybody. I have about $25,000 in unreimbursed claims, and I’m probably better off than most, because we were billing them immediately. Some claims go back as far as August, and they just put them in a holding pattern.”
Urgent Care centers play a critical role in administering COVID-19 testing and treatment, and many were happy to participate in the program. However, being unable to get reimbursed for their efforts has left them frustrated. One member stated they did speak with an HRSA representative and express their frustrations and expectations, and were told, “You’re right, but we don’t have the money.”
Robert Burchfield, Operations Support Manager at Silver Health CARE, a group of Urgent Care centers in southwest New Mexico, is struggling with what to do next.
“There’s about 800 claims on hold right now, sitting on our accounts receivable, that we’re not sure what to do with at this point,” he said. “Basically, we’re faced with either charge the patient or hold off. Personally, I think it’s hard to charge a patient, because initially they were going to be free.”
Proposed solutions are for the participating centers to receive funds to cover the supplies and procedures they provided to patients, or a tax credit to offset these unreimbursed claims. Government action will likely determine how many centers participate in similar future programs.
“The next thing that comes around, I might not want to provide services,” Sanchez said. “I think we’re not going to want to participate. That’s the biggest thing.”
Burchfield agreed, stating, “It was good initially with the rollout of these vaccines, but it’s the follow-through, that’s the disappointing part of it. How the government responds will impact our decision going forward. We might just decide, maybe not, we won’t participate because what we dealt with the last time.”
If fewer centers participate in these programs, the result would be uninsured patients having fewer options of where to receive care. Urgent Cares exist to support their communities, but they are different from other health care options; they are independently run and need to ensure their viability to keep providing care.
“In the end, we are a business as well,” Burchfield said. “We are providing care, but we have to stay open somehow.”