Important Information Regarding COVID-19
First Choice by Select Health of South Carolina has been closely monitoring the Centers for Disease Control and Prevention (CDC) for the latest information about the coronavirus (COVID-19), and has been engaged in making the necessary plans based on guidance from the CDC. First Choice recommends that providers follow CDC, Centers for Medicare & Medicaid Services, and state-specific guidance with regard to COVID-19 evaluation, testing, diagnosis, treatment, and reporting.
At Select Health of South Carolina, we care about your health and safety. For this reason, we are taking precautions concerning the COVID-19 pandemic.
With the emergency use authorization and distribution of the COVID-19 vaccine, our members will likely be looking to you, their health care provider, for direction. Updates and changes are happening quickly, and Select Health is closely monitoring guidance from local and federal officials to learn the most up-to-date information.
As we continue to learn more, here is what we do know:
- It is important for everyone to continue taking steps to protect themselves by social distancing, washing their hands, and wearing a face covering.
- Distribution of the vaccine has begun, but it will take time before the vaccine is more widely available. We are aware that you may be planning to administer the vaccine to your patients, and we will be interested in collecting more information from you to share with our members.
- For the most current information about who is eligible for the vaccine during and after the public health emergency, visit the South Carolina Department of Health and Environmental Control (SCDHEC) website: https://scdhec.gov/covid19/covid-19-vaccine<.
- According to the Centers for Medicare & Medicaid Services, state-specific regulations will still apply for billing and reimbursement guidance.
- No prior authorization or copay is required.
- Providers will only be reimbursed for the administration of the vaccine, since the toxoid is provided at no cost to the provider.
Three vaccines have received FDA Emergency Use Authorizations (EUAs):
- Pfizer/BioNTech (BNT162b2): 2 doses given at least 21 days apart.
- Moderna (mRNA-1273): 2 doses given at least 28 days apart.
- Janssen (Ad26): Single dose.*
Select Health encourages our members to speak with you, their trusted health care provider, about the vaccine to help them decide whether to receive the vaccine. According to the Centers for Medicare & Medicaid Services (CMS), this should include communicating with patients who choose to receive either of the two-dose vaccines about the importance of getting both doses.
*According to an FDA news release dated April 23, 2021, the FDA and CDC determined that the recommended pause in the use of the Johnson & Johnson (Janssen) COVID-19 vaccine should be lifted and use of the vaccine should resume. FDA News Release 042321.
The FDA amended the emergency use authorization of the Johnson & Johnson (Janssen) COVID-19 vaccine to include information about a very rare and serious type of blood clot in people who receive the vaccine. For more information, visit: FDA Emergency Preparedness and Response COVID 19.
If you have any questions about engaging members who have limited English proficiency, sensory impairment, and/or low literacy levels, please contact Member Services at 1-888-276-2020.
First Choice will cover all medically necessary services required to facilitate testing and treatment of COVID-19 for its eligible members, in accordance with federal and state guidance. No prior authorization is required for COVID-19 testing. Coronavirus testing codes follow:
|0202U||Infectious disease detection by nucleic acid|
|87426||Coronavirus AG IA|
|87428||Coronavirus and Inf A&B AG IA|
|87635||Infectious agent detection by nucleic acid, COVID-19|
|87636||Infectious agent detection by nucleic acid, COVID-19|
|87637||Infectious agent detection by nucleic acid, COVID-19 & Inf A&B|
|87811||Infectious agent detection by nucleic acid, COVID-19, Inf A&B &RSV|
|C9803||Hospital outpatient clinic visit, COVID-19 specimen collection|
|G2023||Specimen collection, COVID-19|
|G2024||Specimen collection, COVID-19 individual|
|U0001||CDC COVID-19 real-time PCR diagnostic panel|
|U0002||COVID-19, any technique, non-CDC|
|U0003||Infectious agent detection by nucleic acid, COVID-19, high throughput|
|U0004||COVID-19, any technique, non-CDC, high throughput|
Reminder: In accordance with SCDHHS guidelines, Select Health South Carolina continues to waive co-payments for evaluation and management (E/M) code range 99201-99499 for dates of service on or after March 15, 2020.
CDC links for more information:
If you suspect you or a patient has COVID-19
The CDC instructs providers to consult with local or state health departments to determine whether patients meet criteria for a Persons Under Investigation (PUI). Providers should immediately notify infection control personnel at their facility if they suspect COVID-19 in a patient. Please notify your state or local health department if a patient is classified as a PUI for COVID-19.
Providers should report recognized exposures, regularly monitor themselves for fever and symptoms of respiratory infection, and not report to work when ill. Providers in low-, medium-, or high-risk exposure categories who develop signs or symptoms compatible with COVID-19 are strongly encouraged to contact their established point of contact (public health authorities or their facility’s occupational health program) for medical evaluation prior to returning to work.
CDC links for more information:
- CDC: Healthcare Professionals: Frequently Asked Questions and Answers
- Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease (COVID-19)
Access and Availability to Care — Office Closures and Use of Telehealth During the COVID-19 Response Period
Select Health of South Carolina continues to monitor the latest information regarding COVID-19, and wants to help ensure that our members have access to care for their health care needs. To help accomplish that, we ask that any participating provider who will be closing their office for an extended period of time notify Select Health of South Carolina at 1-800-741-6605, and patients/members, and indicate whether virtual visits, telephonic consultation, and/or secure web-portal consultation will be available during this period.
Select Health of South Carolina covers telehealth visits for our members in accordance with state and federal policy. Similar to Medicare, many states are adopting expanded or interim policies related to the originating site, payment for telephonic visits, and expanded licensure.
If your office plans to close or limit onsite visits, and provide virtual, telephonic, or web-based support, please see updated guidance provided by the state: https://msp.scdhhs.gov/covid19/. You can access recent telehealth guidance from the United States Department of Health and Human Services (HHS) Office for Civil Rights (OCR) here: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html. Select Health of South Carolina will provide updates as we receive them.
If your office is closing for an extended period of time and not offering virtual, telephonic, or web-based visits, please direct your patients who are our members to contact Select Health of South Carolina Member Services at 1-888-276-2020 (TTY: 1-888-765-9586). We have tools in place to connect members to alternate providers who can support their continued care. Members can also receive support by calling our 24/7 Nurse Call Line at 1-800-304-5436.
Access to Language Services for Patients With Limited English Proficiency (LEP)
Select Health of South Carolina is dedicated to providing culturally competent health care. To support this effort, we offer interpretation services at no cost for our First Choice members. LSA's INTERPRETALK® program provides a fast and easy way to communicate with our LEP members. They have interpreters in more than 200 languages who are available 24 hours a day, seven days a week.
Connecting with an interpreter
Call Member Services at 1-888-276-2020 (Monday – Friday, 8 a.m. – 9 p.m.; Saturday and Sunday 8 a.m.-6 p.m.) to access this free service. After hours, contact the 24/7 Nurse Call Line at 1-800-304-5436 to connect to an interpreter.
Be prepared to:
- Provide the member's name.
- Provide the Medicaid or First Choice ID number.
- Tell the member's preferred language.
- Ask for a medical interpreter.
After you provide this information to our Member Services department or the Nurse Call Line, you will be connected to an interpreter. Explain the objective of the call to the interpreter and then proceed by speaking to the member in the first person.
Mental Health Resources for Providers
As a result of the COVID-19 pandemic and social distancing, many Americans are now dealing with depression, loneliness, and other mental health challenges, especially among the most vulnerable: those living alone; those with pre-existing physical and behavioral health conditions; and those lacking food, shelter and other resources.
Caring for your patients during COVID-19 may result in heavier workloads and increased stress. As you take care of others, it is also important to take care of yourself. The resources below include helpful reminders and resources for you and your patients.
- CDC Emergency Responders: Tips for taking care of yourself
- CDC COVID-19 Stress and Coping
- Mental Health and COVID-19 — Information and Resources
- Mental Health America Resources for Mental Health Providers
- SAMHSA First Responders and Disaster Responders Resource Portal
Members may refill their prescription medicines (non-opioid/non-controlled substance) earlier than usual to help ensure a sufficient supply. Medicaid members may also receive a temporary, 72-hour supply of medicines that normally require a prior authorization. Use of out-of-network pharmacies will be authorized upon member request when access to in-network pharmacies is difficult, unsafe, or not practical.
Use of certified out-of-network and/or out-of-state providers will be allowed for medically necessary services.
For more resources and guidance, please access the CDC COVID-19 homepage or South Carolina's Department of Environmental Control (SCDHEC).