Coronavirus (COVID-19) Provider and Community Partner FAQ

• Click to learn more about support for physicians during the COVID-19 pandemic.

  There are local and national lines available for physicians looking for emotional support during this time.

  1. OPAL-C emotional support for providers: The Oregon Psychiatric Access Line (OPAL) is now opening OPAL-C (COVID-19), providing emotional support to prescribing providers in the state.
     • 503-346-1000, 9 a.m. to 5 p.m. Monday through Friday
  2. Physician Support Line: Free, confidential, national support line run by volunteer psychiatrists.
     • 888-409-0141, 5 a.m. to 9 p.m. every day
     • physiciansupportline.com

• Information on the codes to use when testing for testing for COVID-19 diagnostic detection and antibody presence.

  For guidance on test ordering, specimen collection and processing please consult your contracted lab, hospital or the OHA for the state lab. Medicare and the AMA have released the following codes for use when testing of COVID-19:
  
  

  COVID-19 diagnostic testing

  • Medicare:
    • U0001: SARS-CoV-2 diagnostic tests performed specifically at CDC testing laboratories.
    • U0002: SARS-CoV-2/2019-nCoV diagnostic tests performed at non-CDC testing laboratories, otherwise known as the novel coronavirus or COVID-19.
    • U0003: Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies.
    • U0004: 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies.
  • AMA:
    • 87635: Severe acute respiratory syndrome coronavirus 2 (SARS-2-CoV-2) (coronavirus disease [COVID-19]).

  COVID-19 antibody testing

  • 86328: Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single step method (e.g., reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]).
  • 86769: Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]).
  • 87426: Infectious agent antigen detection by immunoassay technique (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID-19]).
  • 0223U: Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected.
  • 0224U: Antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), includes titer(s), when performed.

  During the COVID-19 emergency, CareOregon will follow Oregon Health Plan (OHP) coverage guidance for COVID-19 antibody testing. COVID-19 antibody testing (also known as serology testing) to diagnose SARS-CoV-2 coverage criteria:

  • Uses tests that have FDA Emergency Use Authorization (EUA) or FDA approval and
  • Is to evaluate a hospitalized person under age 21 for possible multisystem inflammatory syndrome in children (MIS-C).

   

• Resources, codes, and additional reference material related to telephone and video appointments (telehealth/telemedicine).

  Current codes and guidance for telephone and/or video appointments

  • Telemedicine technical assistance guide
  • Behavioral health technical assistance guide
  • Telehealth FAQ for providers
  • Primary care providers: Codes for telehealth and other communication-based services in response to COVID-19
  • Behavioral health providers: Codes for services via telephone in response to COVID-19
  • Dental providers (CareOregon dental providers and members ONLY): Teledentistry Codes for COVID-19
  • Expanded teledentistry guidance, including preventive services

  Additional telehealth reference material

  • OHA COVID-19 for Oregon Health Plan partners (benefit information)
    • Provider Guide
    • April 17 webinar
    • April 17 webinar Q&A
    • Expansion of fee-for-service telemedicine coverage, including telephone services during an epidemic of an infectious disease
    • DCBS-OHA telehealth guidance
    • OHA expanded telehealth for behavioral health
  • Medicare telemedicine health care provider fact sheet (3/17)
  • HHS: Notification of enforcement discretion for telehealth remote communications during the COVID-19 nationwide public health emergency
  • COVID-19 public health emergency response and 42 CFR part 2 guidance
  • Payment parity implementation for two-way audio-video visits

• Information specific to behavioral health providers during the COVID-19 pandemic.

  • Behavioral health access report
  • Mental health considerations for older adults and individuals receiving care in facility-based settings during the COVID-19 pandemic
  • COVID-19 prioritization guidelines for behavioral health populations
  • Substance Abuse and Mental Health Services (SAMHSA): Coronavirus resources
  • SAMHSA: Medication-assisted treatment guidance
  • Practitioners Clinical Support System: Telemedicine guidance on Buprenorphine
  • American Society of Addiction Medicine: Alcohol withdrawal management
  • HHS: Emergency situation preparedness, planning and response
  • Oregon SUD Resources Collaborative
  • Oregon Recovery Network: Recovery support resources
  • American Academy of Family Physicians: Virtual visit algorithm
  • U.S. Department of Justice Diversion Control Division: COVID-19 information
  • Synergy: Pain Flares: A peer’s perspective
  • Synergy: Flare-ups during COVID-19
  • COVID-19 and chronic pain management
  • Resource digest - June 19, 2020
  • Resource digest - June 26, 2020
  • Resource digest - July 10, 2020
  • Resource Digest - August 17, 2020
  • Resource digest - August 24, 2020
  • Resource Digest - September 22, 2020
  • Master Resource List

• Pharmacy updates, resources, and information. This section includes some updates on specific medications.

  • Up to a 90-day supply of medications is allowed
  • For more details: CareOregon pharmacy benefits (Medicaid)
  • For more details: CareOregon pharmacy benefits (Medicare)
  • CareOregon Clozapine Advisory
  • CareOregon Long-Acting Medication Advisory
  • Pharmacy Resource List

• Other useful resources related to COVID-19, including links to state and federal resources.

  • OHA COVID 19 updates
  • CDC COVID 19 guidance
  • AAFP: Prepare for corona (COVID-19)
  • OHA Strategies to limit spread and increase capacity
  • OHA guidance for health systems regarding COVID-19 testing
  • OHA infection control guidance for in-person interpreters and providers
  • Oregon Medical Board topic of interest COVID-19
  • COVID-19 guidance: Non-emergent medical transportation (NEMT)
  • CareOregon Dental COVID-19 guidelines for providers
  • UCSF School of Medicine: Contraception during COVID-19: Best practices and resources
  • Better Care Playbook: Addressing complex care needs amid COVID-19
  • Federal Communications Commission: COVID-19 telehealth program
  • Drive-thru primary care: Tips and considerations
  • COVID-19 communication for members who are deaf or hard of hearing
  • COVID-19 communication for members who cannot speak
  • Visual communication tools for members with disabilities
  • Note: Providers serving Medicaid members may not charge members for personal protective equipment (PPE) used during their visits. Medicaid regulations require that providers accept Medicaid payment as payment in full, meaning providers are not allowed to bill Medicaid members for any extra PPE that may be required to perform medical or dental services. Clinics are responsible for providing PPE for all members of the care team, including interpreters.

• Learn about health-related services to cover immediate member needs like cell phones and hotel rooms. Find the forms you need to request health-related services.

  Limitations of health-related services: The Oregon Administrative Rules restrict health-related services to items not paid for with grant money, funding separate from CCO contract revenue, or normal clinical service billing. In other words, health-related services may be used only if other funding is not available. Before you make a request, please be sure there is no other funding available.
  
  

  CareOregon is continuing to offer health-related services of many kinds, but in particular we are striving to meet the most immediate member needs:

  • Cell phones: With many providers moving to delivery of services via telehealth, we want to ensure that members have access to a phone. We are working with a provider to offer flip phones and simple smart phones to members.
  • Hotel rooms: For members who are at higher risk due to underlying health conditions, have been exposed to COVID-19 or are showing signs of the virus, we are attempting to find hotel rooms where members can stay while they await test results or other care that does not meet the criteria for the county’s motel sheltering program.

  There are two ways you can submit requests for health-related services for members:

  1. Use our standard Health-Related Services Flexible Services Funding Request form to make requests for cell phones, hotel rooms or other health-related services for individual members.
     1. Please remember that requests for health-related services must be directly related to members’ treatment plans and require chart notes to justify the request.
  2. Bulk items are available to help clinics and providers ensure a constant supply of the most needed items. To order items in bulk — including cell phone minutes, transit passes, sleeping bags, hygiene projects and more — fill out our Bulk Purchase Request form.
     1. Bulk requests may take up to 14 business days for review and delivery. 
     2. Clinics and county teams may make bulk requests one time per month. 
     3. Requests should be submitted by supervisors or managers. 
     4. Clinics/teams are required to keep a Bulk Request Tracking document and submit it before new orders can be fulfilled. 

  Download the COVID-19 health-related services resource worksheet:

  • English
  • Spanish

• The guidance being given to members/patients during the coronavirus pandemic. If you have questions about what to tell patients, this section can help. This includes links to interpretation services.

  • If a member has symptoms of COVID-19, CareOregon is recommending they call their primary care provider. You can best advise members on the next steps, including how to get tested.
    
    
  • We are encouraging members to stay at home and practice social distancing whenever possible. We are reinforcing that this is the most effective way to help prevent the spread of COVID-19.
    
    
  • You should notify members about how appointments are being handled. We are ensuring members that clinics are still seeing patients — both in person and via telehealth — and taking precautions to keep members and staff safe.

  • We are urging clients receiving mental health and substance use treatment services to contact their providers directly to learn how to access services. Many providers are shifting to offering services by phone, though some in-person visits are still available. Please see the telehealth and phone-based services guidelines for behavioral health included above.
    
    
  • Elective procedures have resumed. To reduce the administrative burden on providers and reassure members, authorizations for elective procedures are being extended until January 1, 2021.
    
    
  • Members still have access to CareOregon’s provider network. None of their benefits have changed, and CareOregon is still committed to helping members meet their physical, dental, mental health and addiction-related care needs.
  • Refills: If members get their prescription refilled, we will extend their prescription to 90 days’ worth of medication. They also have the option to receive prescriptions from a mail-order pharmacy. If a member has an approved pre-authorization that expires before the end of the year, they should check with their provider to see if the pre-authorization can be extended.
    
    
  • Members and providers still have access to interpretation services. CareOregon’s approved interpretation vendors are Passport to Languages and Linguava. To arrange for an interpreter to be present during an appointment — whether by phone or in-person — complete the CareOregon Interpreter request form found on our Provider Policies and Forms webpage. You can also access our vendors’ online systems to request and confirm an interpreter:
    • Passport to Languages:passporttolanguages.com
    • Linguava:portal.linguava.com/Account/Login
  • Rides to appointments are still available for members. Members should call NW Rides at 888-793-0439 to ask about service availability.

  We’ve provided answers to other common questions below. This page will continue to be updated with more information as it becomes available. 

Please click on a FAQ below to expand.

• Q: Who is at risk of getting the coronavirus?

  A: With cases in the United States increasing, everyone is at some risk of getting COVID-19. Older adults and people with existing medical conditions are at a greater risk. For the latest information about the risk and precautions in Oregon, visit the Oregon Health Authority.

• Q: How can members prevent the coronavirus?

  A: According to the CDC, steps one would normally take to prevent the flu and the common cold can also help prevent the spread of the coronavirus:

  • If someone is sick, avoid contact with them. The coronavirus can spread between people about six feet from each other.
  • Cover coughs and sneezes with a tissue. Throw used tissues in the trash.
  • Clean items in the home that are touched often. Use wipes or sprays to disinfect.
  • Wash hands with soap and water often, for at least 20 seconds. Wash:
    • After going to the bathroom.
    • After coughing or sneezing.
    • Before eating.
    • Before touching the eyes, nose or mouth.
  • Use hand sanitizer with at least 60% alcohol if soap isn’t available.

• Q: Do members need face coverings?

  A: The CDC now recommends that people wear face coverings in settings where social distancing is difficult to maintain, like in grocery stores or pharmacies. Anyone who shows symptoms of coronavirus or is in close contact with people who have symptoms should wear a face covering. The CDC has guidelines for homemade coverings. CareOregon recommends that if a member needs a professional-grade mask because they’re sick, or are caring for someone who is sick, they should talk to their primary care provider. CareOregon only provides face coverings to staff who fit criteria for having a clinical need for respiratory protection, and who have completed medical screening and fit testing.

• Q: Can members get extra medicine if they can’t make it to the pharmacy?

  A:  If members want to refill their prescriptions, their prescriptions will be extended to 90 days’ worth of medication. If a member has other questions or concerns about the medications they take, we recommend they contact their prescribing provider or their pharmacist. Providers and pharmacists can help guide members on best next steps.

  Columbia Pacific CCO is in close contact with the Oregon Health Authority and is following CDC guidelines. Members can visit the Columbia Pacific CCO website at colpachealth.org/covid-19 for the latest information.

• Q: Are there medication treatments for the coronavirus that are covered?

  A: According to the CDC, there is no specific treatment for the coronavirus. We recommend members contact their primary care provider if they have symptoms and believe they need care. We are reinforcing that their primary care provider is the first person they should call.

  
  

• Q: What should members do if they have more questions or want to learn more?

  A: The Center for Disease Control and Prevention (CDC) is monitoring the situation closely. Members can learn more at cdc.gov/coronavirus/2019-ncov. They can also call 211 or visit the 211 website at 211info.org/corona-virus for more general information.

  OHA has posted some helpful fact sheets that can be found here:

  • COVID-19 fact sheet
  • Prevention fact sheet

• Q: Is Columbia Pacific CCO providing tissues, hand sanitizer, disinfecting wipes or other supplies to their partners?

  A: Sourcing these items is difficult for everyone, including Columbia Pacific CCO. We do not stock supplies or maintain a surplus. While we understand the need we do not have the resources to assist with additional supply needs. See OHA’s March 9 statement for more information.

• Q: How is Columbia Pacific CCO handling embedded staff, e.g., care coordinators, panel coordinators, etc.?

  A: If there is a Columbia Pacific CCO staff member embedded in a clinic, we are telling them to follow their respective clinic’s guidance regarding COVID-19. If they have any additional concerns, we’ve asked them to reach out to their Columbia Pacific CCO supervisor.

  If you have a question specifically about Columbia Pacific CCO staff in your clinic, please ask for their supervisors contact information.

• Q: Who is Columbia Pacific CCO following for guidance?

  A: This is an evolving situation that we are monitoring closely. Columbia Pacific CCO is aligning with current CDC, OHA and each county's public health guidance and we are continuing to monitor and share information.

• Q: Will interpreters still be available for member appointments?

  A: CareOregon supports and encourages in-person interpretation, and we want to make sure that interpretation needs continue being met. Clinics can schedule a telephonic interpreter through Linguava, Passport to Languages. or by calling CareOregon Provider Customer Service.

• Information about what to do if you think someone in your care has coronavirus, and other resources for clinic staff.

  What should clinic staff do if they suspect someone in their care has the coronavirus? 

  Please reach out to the CDC, OHA or Multnomah County. They can help you with any suspected cases and suggest the appropriate next steps. 

  Resources for health care staff: 

  • CDC: cdc.gov/coronavirus/2019-ncov/hcp/caring-for-patients.html
  • OHA: oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Pages/emerging-respiratory-infections.aspx
  • Multnomah County: multco.us/novel-coronavirus-covid-19

  Who should we call if we have questions? 

  If providers or clinic staff have other questions about COVID-19, they should reach out to OHA directly.