COVID-19 background

Elation Health COVID-19 Financial Guide

We’re committed to ensuring your success in dealing with the economic effects of COVID-19. This resource guide provides an overview of financial assistance available to independent practices during and after this difficult time so independent physicians have the information they need to make the right decisions for their businesses and patients.

Federal Relief Programs

This matrix helps break down the different types of federal relief options available for application to determine which one or ones are appropriate for you. Immediate financial payment can be available as quickly as 3 days following application submission.

Paycheck Protection Program (PPP)Economic Injury Disaster Loan (EIDL)
(The SBA is currently unable to accept new applications based on available appropriations funding.)
Express Bridge Loan
Best ForSmall business intending to maintain current staff and payroll.Small business in need of expedited cashflow.Small business with an existing relationship with a SBA Express Lender.
Loan AdministratorSBA Lender or participating FDIC-insured lender/credit unionSBASBA Express Lender
Loan Relief Amount2.5x avg monthly payroll costs ($10M cap)Based on amount of financial injury ($2M cap)$25K
Who Can Apply?< 500 employees
In business prior to Feb 15, 2020
< 500 employees
< 500 employees
Existing relationship with SBA Express Lender
In business prior to Mar 13, 2020
Loan Coverage PeriodFeb 15, 2020 – Dec 31, 2020Jan 31, 2020 – Dec 31, 2020Mar 25, 2020 – Mar 13, 2021
Loan AdvanceNone$10,000 within 3 daysNone
Interest1%3.75%Capped at 6.5%
First Loan Payment Due6 months after origination date1 year after origination dateLenders may require full/partial repayment if you are approved for long-term financing
Term5 years30 years7 years
Loan ForgivenessYesNoNo
CollateralNoYes > $25,000No
GuaranteeNoYes > $200,000No
How to apply(The SBA is currently unable to accept new applications based on available appropriations funding.)
How to apply
How to apply

Virtual Services Billing Guidelines

If your practice is exploring alternative methods to remotely check-in with your patients and evaluate their health, there are a number of telemedicine services that may be reimbursable by CMS and private payers, or services you may decide to fold into your membership or cash-based offerings. CMS specifically categorizes virtual services into 4 groups: telehealth visits, virtual check-ins, eVisits and (new) telephone-only E/M.

See the table below for billable codes associated with each of these telemedicine services. As coding requirements may differ by payer, we recommend confirming requirements before you submit your claims.

TelehealthVirtual Check-insTelephone E/MeVisits
Communication Mechanism2-way interactive audio-visual
Note: Some states are allowing audio only*
Phone call or Image/video sent by patient and reviewed async by providerPhone callHIPAA compliant patient portal/secure messaging system
Medicare FFS BillingCPT Codes
– 99201-99205
– 99211-99215
– G0438-G0439 (AWV)

For Facility Rate:
– POS 2
– Generally no modifier, unless GQ for Alaska/Hawaii federal demonstration program

For Non-Facility Rate:
Generally higher reimbursement
– POS 11
– Modifier 95
Phone:
– G2012

Image/video:
– G2010
Qualified Non-Physician:
– 98966-98968

Physician:
– 99441-99443
Qualified Non-Physician:
– G2061-G2063

Physician:
– 99421-99423

For additional information on billing and workflow recommendations for virtual services, please visit this link.

If you are seeing non-member patients, we recommend taking the following steps:

  1. Create a rate for Telehealth visits. Most practices will apply their general face-to-face visit fees, matching a similar payment pattern seen in the fee-for-service model.
  2. Create a mechanism to track these patients to distinguish them from membership patients. If you are Hint-integrated, use a patient tag to track “non-Members” in Hint. If you are not Hint-integrated, use a patient tag to track “non-Members” in Elation

Additional COVID-19 Programs

Please refer to our Additional COVID-19 Programs for details on payer-/service- specific financial relief programs. We will make frequent updates to this listing as new programs become available.

FAQs

Common questions and concerns about our financial guide can be found in our FAQs.
If you have any questions, click here to contact us: