Beginning Saturday, new federal rules will require private insurers to cover the home coronavirus tests Americans buy in pharmacies and other stores. The new system could theoretically allow millions of people to pick up tests in thousands of locations without spending any money.
The reality, at least in the short term, will likely be messier: Some insurers say it will likely take weeks to fully set up the system envisioned by the White House.
The new process will be difficult, the insurers say, because over-the-counter coronavirus tests are different from the doctor visits and hospital stays they typically cover.
The tests currently do not have the type of billing codes that insurers use to process claims. Health plans rarely process receipts; instead, they’ve built systems for digital claims with preset formats and long-standing billing codes.
Therefore, some insurers plan to manually manage the quick test claims in the beginning.
“This takes things back to the old days where you have a person throw all these paper slips in a shoebox and end up putting them in an envelope and sending them to a health care provider to decipher,” said Ceci Connolly, the chief executive of the Alliance of Community Health. Plans, which represents smaller nonprofit insurers.