Uninsured individuals in the U.S. without health care coverage are eligible. To document patient eligibility, providers will need to submit unique identifiable information about uninsured individuals as determined by HRSA (subject to adjustment as necessary).
to Patient RosterLess than 24 hours
PaymentApproximately 10 business days
Once a TIN is validated and set up with Optum Pay, claims that are eligible for reimbursement are typically processed and paid within 30 business days.
1. Enter Patient Information
Complete patient attestation and upload patient roster with the following information:
You Will Need
- First and last name
- Date of birth
- *SSN and state of residence; if not available, enter state identification / driver's license
- Date of service for professional, institutional outpatient services
- Date of admission and date of discharge for institutional inpatient services
- Middle initial (optional)
- Patient account number (optional)
*A SSN and state of residence, or state identification / driver's license is needed to verify patient eligibility. If a SSN and state of residence, or state identification / driver's license is not submitted, you will need to attest that you attempted to capture this information before submitting a claim and the patient did not have this information at the time of service, or that you did not have direct contact with the patient and thus did not have an opportunity to attempt to capture this information. Claims submitted without a SSN and state of residence, or state identification / driver's license may take longer to verify for patient eligibility.
**If the individual is unable or unwilling to provide their address, please add the address of the facility where the care was provided or other location that may be appropriate (e.g., shelter).
As part of this step, if you have direct contact with the patient, you should make best efforts to confirm that the patient was uninsured at the time the services were provided (i.e., for claims for COVID-19 Testing and Testing-Related Items and Services, verify that the patient does not have coverage through an individual or employer-sponsored plan, a federal health care program, or the Federal Employees Health Benefits Program; for claims for treatment of a COVID-19 diagnosis, verify that the patient did not have any health care coverage; for COVID-19 vaccine administration, verify that the patient did not have any health care coverage). If you do not have direct patient contact, you may rely on the attestation of the ordering health care provider that the patient’s health coverage status is uninsured.
3. Receive Temporary Member ID
Claims can still be submitted after the date of validity, but the temporary member ID must be eligible for the date of service or admittance.
Receive a temporary member ID for each individual after submitting patient information, which will be displayed in the program portal in less than 24 hours.
For professional and institutional outpatient – Temporary member ID will be valid for 120 days from date of service. Eligible claims can be submitted using the temporary member ID with date of service within the validity period. For example, if Patient A had a date of service of February 4, 2020, then the temporary ID assigned to her will be valid from February 4, 2020, through June 3, 2020.
For institutional inpatient – Temporary member ID will be valid from date of admission and expire 120 days from date of discharge. Eligible claims can be submitted using the temporary member ID with date of admission and date of discharge within the validity period. For example, if Patient B had a date of admission of February 4, 2020, and date of discharge of February 20, 2020, then the temporary member ID assigned to him will be valid from February 4, 2020, through June 19, 2020.
Note: If an uninsured individual was treated in the ER before being admitted as an inpatient, use the date of admittance to the ER as the inpatient admittance date.
Note – A temporary member ID will not be issued if active coverage is identified. If a provider believes this coverage information is outdated or not applicable, they may request reconsideration of eligibility.
For status updates on TIN validation, provider roster verification and Optum Pay™ account setup,
check the provider dashboard on the main page of the program portal.