By Sanjay Basu, M.D., Ph.D. and Rajaie Batniji, M.D., D.Phil.
This is a challenging time for all of us. To support not only our members and clients, but also the general public we launched a dedicated Collective Health COVID-19 Resource, focused on helping everyone stay healthy, safe, and informed, and which now includes the COVID-19 Risk Assessment tool.
TESTING FOR CORONAVIRUS COVID-19
At this time in the US, many people concerned about COVID-19 will not be able to get tested immediately due to limited availability.
Collective Health’s COVID-19 Risk Assessment is available to help you determine whether or not you may be appropriate for COVID-19 testing. Our COVID-19 Risk Assessment was developed by in-house medical experts, and with direct insight into the questions and concerns top-of-mind for people right now. Learn more here.
NOTE: This tool is not for diagnostic purposes and is not intended to substitute for personalized medical advice from your healthcare provider, but may be useful to help understand current CDC guidelines and local health department guidelines for testing.
Collective Health is tracking the situation closely. As of Monday, March 30, the testing capacity of the United States was expanding, but remains delayed for many patients.
Newer molecular tests have been developed and are now rolling-out across the country. We anticipate these will make it possible to expand testing in the coming weeks, though their availability remains limited at this time.
Many organizations released information suggesting they will provide point-of-care or at-home testing. While this is positive news, it’s important to ensure tests are of high quality and that people are able to obtain a sample sufficient enough to run the test. It is also critical that these test results be reported appropriately to public health authorities. We continue to follow FDA guidance on testing and encourage members to do the same to ensure you receive accurate results.
Several factors led to limited testing capacity: 1) initial test kits sent to state and local laboratories did not work as intended, 2) restrictions were placed on state and local laboratories from deploying independent tests 3) the global supply chain for key testing materials has been under strain. The CDC has also advised healthcare professionals to prioritize testing for symptomatic people.
COVID-19 testing is covered under almost all private and public insurance. This includes all Collective Health members, but having coverage does not mean you won’t face costs related to testing and evaluation. We are closely monitoring the availability and effectiveness data on new treatments, and our Collective Care team is advocating for access to clinical trials and of treatments for members with severe illness.
Collective Health is working with employers to change plan designs and help offset the costs of COVID-19-related testing and treatment to members. Keep in mind, other elements of your care may have regular cost-sharing. Our member applications and websites have been reflected to show your plan’s specific cost-sharing for COVID-19 testing and treatment.
If you are a Collective Health member facing challenges related to COVID-19, our Member Advocates can share benefit plan specifics and potential costs. We also actively monitor claims related to COVID-19 to help minimize the risk of surprise billing to members. Additionally, Collective Care, our specialized care management team, may be able to help if you need to find a healthcare provider to evaluate you for testing or if you are trying to arrange home delivery of other medications and avoid the infection risk of going to a busy pharmacy.
Healthcare capacity to handle individuals sick with COVID-19 remains limited, with many hospitals overwhelmed. There is particular concern about the limited number of intensive care unit beds, and the limited number of ventilators available to assist people who experience Acute Respiratory Distress Syndrome ( ARDS) or related pulmonary complications that may result in their need for mechanical ventilation.
A recent proposal to improve ventilator production and distribution has mobilized some tech and manufacturing sector companies, though much remains unclear about whether new production will ultimately meet supply. Additionally, government authorities have distributed ventilator supplies, though there have been problems with reliability of these ventilators. Fortunately, both government and private services are opening new sites that may be used as healthcare centers; Collective Health is tracking these sites and observing their clinical standards and their suitability for members should their need arise in areas with overwhelmed traditional hospital capacity. At this time, we are working in particular with member populations in New York City to facilitate transfers to accepting Centers of Excellence with greater ventilator capacity, as ICUs in the City remain overloaded.
For our members who may need to be taken to the emergency room, we recommend ensuring you or your family tell paramedics where your usual source of care is. This way they can coordinate with hospitals to determine which facility has your medical records and can continue supporting you with the details of your care needs.
If you have questions about the details of your coverage or about paying for testing or treatment, contact our Member Advocates by phone, our website, or through the Collective Health app.
If you have questions about COVID-19, our Member Advocates are ready to answer them and more than happy to assist you. Continue familiarizing yourself with prevention and testing information from the CDC and the WHO.
Some specific steps Collective Health has taken to help you and your family during this time:
- Working to ensure your health plans cover associated medical evaluation and, if indicated, appropriate testing and treatment. There are no prior authorizations required for COVID-19 diagnostic testing.
- Member Advocates are prioritizing responses to members with COVID-19 related inquiries and are here to help with locating a provider who can evaluate you for symptoms and further testing.
- If you’re looking for a provider, our Get Care feature in your Collective Health app is always available to help you find a physician nearby.
- Collective Care, our care management team, may be able to provide support for members with potential exposure or who exhibit symptoms consistent with COVID-19. Collective Care may be able to also help safely and accurately triage to available testing and treatment centers, while coordinating steps to reduce their risk of transmission.
- Working with our pharmacy partners to ensure easier access to medications for all members, including free medication delivery and extended or emergency refills for eligible members.
- If you want to submit a claim, appeal, or grievance, send it electronically through the Collective Health app so we can review it right away.
We proactively provide the most up-to-date and effective recommendations to help you keep your people healthy and navigate the healthcare system, especially in this time of need.
We are also tracking the volume of inquiries to Collective Health Member Advocates about COVID-19, and the utilization of telemedicine partners, to ensure that our clients are able to respond effectively to the needs of their populations.
We’ve designed new benefits policies that reduce out-of-pocket costs and surprise billing, encouraging members to visit their doctor or use telemedicine for COVID-19 evaluation. We’ve added an additional policy for clients to support members’ continuity of care through telemedicine if not otherwise covered.
Collective Health itself is ensuring the continuity of our operations and ongoing support of our critical client and member services.