COVID-19 Testing and Treatment
Following the release of new CMS guidance, we’re waiving all member copays for COVID-19 testing. We are also waiving prior authorization (PA) requirements for testing.
How to order testing
For patients who meet current guidance for evaluation of COVID-19, order the test from either of Devoted Health’s laboratory partners, Quest Diagnostics or Labcorp.
Do not send patients to a LabCorp or Quest Diagnostic location. Instead, collect the appropriate specimen at the healthcare facility where the patient was seen and the test was ordered. Appropriate specimens include:
- Nasopharyngeal (NP) or oropharyngeal (OP) swab in viral transport medium
- NP or OP washes/aspirates in sterile cups
- Bronchial washings or bronchoalveolar lavage (BAL) specimens in sterile cups
Coverage of COVID-19 treatment will follow our regular health plan policy. We'll cover primary care physician (PCP) visits and hospital stays as normal.
For emergency inpatient admissions related to the treatment of COVID-19, we require only notification. CT scans of the chest do not require a PA per existing policies. As our knowledge of COVID-19 evolves and treatment patterns become more clear, we will continue to monitor our PA list to ensure timely access to care for members.
At this time, Devoted Health members are covered for all CPT/HCPCS codes payable as telehealth when billed under Original Medicare with Place of Service 02. We're also waiving member copays for these services. For more details on covered services, see:
- 2020 telehealth services payable under Original Medicare
- Recently expanded list of reimbursable telehealth services
Our Messaging to Members
To keep our members safe, we’re asking them to practice social distancing and to stay home. We’re also reaching out to high-risk members to make sure they have the medication, food, and resources they need.
We tell our members to call their PCPs right away if they have cough, fever, or shortness of breath and think they may have COVID-19. We emphasize that they should call before going in for an appointment.
When members with COVID-19 symptoms call us for medical advice (which is rare), we share 2 recommendations:
- Use acetaminophen for fever or pain relief, not ibuprofen
- Continue taking ace-inhibitors and angiotensin receptor blockers, per guidance from the American College of Cardiology
We've lifted early refill restrictions so members can get an early refill for a 30-day supply of their medication. And we’re encouraging members to take advantage of CVS free delivery and mail order.
How You Can Help
To encourage our members to stay home, we’re asking our partners, hospitals, and providers to consider adopting the following practices:
- Have a phone process in place so those with COVID-19 symptoms can avoid office visits or urgent care (when possible and clinically safe)
- Cancel all in-person, nonessential visits
- Cancel all elective procedures as recommended by CMS
- Use telehealth visits when possible (see the latest CMS guidance)
- Ask members to sign up for mail-order (it's safer, cheaper, and better for adherence) and send 90-day scripts with 3 refills to the mail-order pharmacy
- Have nonessential personnel work from home
Who’s at Risk
Check the latest CDC guidance on the clinical and epidemiological criteria for COVID-19 infection risk.
We’ll continue to keep a close eye on what’s happening with the virus. If you have any questions, call our Provider Services team at 1-877-762-3515.