Information for CountyCare Providers on COVID-19
All of us at CountyCare want to extend our deep appreciation for the work our providers are doing under very challenging circumstances. Please note that we are communicating with our members on a frequent basis with regard to preventing the spread of COVID-19. We are having members reach out first by phone to their providers for direction if they experience symptoms. Per your contract, you are required to have 24 hour coverage, 7 days per week. We thank you for being the first line of defense for our members.
CountyCare is actively monitoring the rapidly evolving coronavirus outbreak, including guidance from trusted sources of clinical information such as the Centers for Disease Control (CDC) and World Health Organization (WHO). We are focused on ensuring the well-being of our members during this crisis, with a particular focus on the most vulnerable. In addition, we are adjusting our business processes to facilitate and simplify access to care.
Below you can find the most up-to-date information regarding how CountyCare is responding to the COVID-19 public health emergency. We have included COVID-19 related testing, coding and other general information for our health care providers. Please save this page and check back often for updates.
Frequently Asked Questions
CountyCare will cover all diagnostic testing for in network providers for medically necessary lab tests to diagnose COVID-19. Your CountyCare doctor doesn’t have to ask us for the OK to test for COVID-19.
Patients who have concerns that they may have been exposed to COVID-19 or may have symptoms of COVID-19 should contact their provider or local/state Department of Health for testing. The test specimens will be obtained and then sent to a laboratory.
There is a shortage of COVID-19 kits available nationally. We encourage you to verify that testing is available before having a patient travel to a test site. Note that all tests require a doctor’s order and that other requirements, such as severe symptoms, may be in effect until testing is more widely available.
CMS has adopted two Healthcare Common Procedure Coding System (HCPCS) codes(U0001) and (U0002), for COVID-19 testing. HFS is using these codes for Medicaid billing purposes.
- U0001 -2019 Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel should be used when specimens are sent to the CDC and CDC-approved local/state health department laboratories.
- U0002 -2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC should be used when specimens are sent to commercial laboratories, e.g. Quest or LabCorp, and not to the CDC or CDC-approved local/state health department laboratories.
If the health plan receives notification of a positive result, we will notify the provider’s office via phone.
Please notify CountyCare of any positive cases at CountyCareQualityofCare@cookcountyhhs.org. Remember to send this communication via secure email to safeguard the privacy of the individual. Continued adherence to Privacy and Security Rules (HIPAA) is very important.
Please include the following information in your message:
- Patient Name, DOB, RIN
- Date of notification of confirmed case
- Date of test
- Date of positive test result
- Current location of member
- Primary Care Provider
Yes, we will allow out-of-network care, however, a prior authorization is required.
Yes. The Illinois Department of Healthcare and Family Services (HFS) has issued new telehealth administrative rules due to the COVID-19 public health emergency. These new rules were developed to enhance access and protect public health during the COVID-19 crisis by giving providers more flexibility to provide services via technology such as video conference or telephone.
Amongst other changes, HFS modified rules on “originating site” to include a patient’s place of residence. No licensed health care professional will be required to be present with the patient at the originating site. Additionally, the types of distant site providers were expanded to include new provider types such as Community Mental Health Centers (CMHCs) and certified Substance Use Disorder providers. In addition, there are new provisions for provider "virtual check-ins" and "E-visits". These expansions are intended to provide remote access to care will help to keep members healthy and prevent further community transmission of COVID-19.
For more information, please see the Telehealth guidance issued by the Illinois Association of Medicaid Health Plans (IAMHP) in conjunction with HFS. This includes a Provider Notice on Telehealth requirements and an updated Billing Guide.
Yes. To encourage social distancing, CountyCare is making the following changes to its pharmacy benefits.
- Refill too Soon. Members or providers can request a one-time refill too soon override for each medication. Contact the Pharmacy Help Desk at 1-888-402-1982. Note that the pharmacy must state that the member has had to evacuate due to a disaster (e.g. COVID-19 pandemic).
- 90 Day Supplies. Members may now obtain up to 90 days’ supply of their medication.
- Coverage for COVID-19. CountyCare will cover all COVID-19 related pharmacy products.
- Mail Order. Members are eligible for free delivery of their medications to their primary shipping address. Members should call MedImpact Mail Order at 1-855-873-8739 Monday-Friday 7am-7pm CST and Saturday 8am-4pm CST. Note that an accommodation can be made to ship to a temporary or alternative address if the patient is quarantined in a different location other than their primary shipping address.
The Pharmacy Help Desk is being staffed to manage increased call volume from our members and providers. The Pharmacy Help Desk is available 24 Hours a day, 7 days a week at 1-888-402-1982.
No. CountyCare’s claims processing, call center and payment processing functions are fully operational.
Yes. The 180-day timely filing limit will be extended to 60 days after the end date of the public health emergency.
No. CountyCare’s appeals processing function is fully operational.
Awaiting further guidance and approval by CMS.
Yes. When the procedure is rescheduled, the provider should contact CountyCare at 312-864-8200. The date range for the prior authorization will then be revised.
Not at this time. CountyCare’s concurrent review function continues to be fully operational.
HFS issued a provider notice on applying for Medicaid coverage during the pandemic. As DHS offices are currently closed, the State of Illinois is encouraging applicants for medical coverage to apply online at www.ABE.Illinois.gov. Applicants are also encouraged to answer all application questions as completely as possible and to submit the application, even if that means the applicant can not submit verification documents at the time of application. To apply by phone, applicants can call the ABE call center at 1-800-843-6154 but may experience long wait times.
Providers who are working with uninsured patients who need testing or treatment for COVID-19 should help patients to promptly apply for medical coverage. For expedited processing, please assist the patient in submitting their application through www.ABE.Illinois.gov and immediately send an email with the application tracking number to HFS.Priority19@illinois.gov. Providers are encouraged to have patients submit an application even if it is unclear as to whether a COVID-19 involved patient may be eligible for medical coverage.