We recommend the following sequence of steps to apply:
- Obtain FCC Registration Number
- Fill out COVID-19 Telehealth Application
- Obtain eligibility determination from USAC
- Register for award management
1. Obtain FCC Registration Number (FRN) FFCCRN is a ten-digit number that is assigned to a business or individual registering with the FCC, and is used to uniquely identify the business or individual in all of its transactions with the FCC.
- Link to obtain FCCRN from CORES: https://apps.fcc.gov/cores/userLogin.do
- Tutorial video: https://www.fcc.gov/licensing-databases/fcc-registration-system-cores/commission-registration-system-video-tutorials
- Each site does not need a separate FCCRN if they are applying under a consortium.
- This FCCRN is needed in order to complete Form 460.
2. Fill out COVID-19 Telehealth Application
Application at: https://www.fcc.gov/covid-19-telehealth-program
- Refer to FCC Application Cheat sheet below for specific answers:
To help us guide you through the application please provide us with your information (see the cheat sheet below for guidance on these questions):
- Lead HCP: the name of your lead clinician
- Facility Name:
- Is the facility a hospital?
- Address:
- Eligibility type (from FCC Form 460)
- NPI
- HCP number (from FCC Form 460)
- EIN or Tax ID number: 9-digit number assigned to businesses by IRS
- Total Patient Population:
- Estimated number of patients to be served by funding: Covid-19 or nonCovid-19 patients
- Information on specific conditions to be treated:
- How has COVID-19 affected healthcare in your geographic area?
- Information about population served- large underserved, low income?
Guidance cheat sheet to the Telehealth application:
Below are some sample answers to application questions (Customize according to your facility/Practice).
Medical Services To Be Provided with COVID-19 Telehealth Funding (check all that apply)
Additional Information on Medical Services to be Provided: Funding will be utilized to deploy Virtual Care Hub to facilitate which enables rapid outreach to patient population, automatic triage through AI enabled bot with referral to and conducting telehealth visits, and continued monitoring and surveillance of patients outside the hospital.
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Conditions To Be Treated with COVID-19 Telehealth Funding (answer all that apply)
Would you treat COVID-19 patients directly?
X Yes
No
Would you treat patients without COVID-19 symptoms or conditions?
X Yes
No
If you answered "Yes" to the above question, please check at least one box below)
Other infectious diseases
Emergency / Urgent Care
X Routine, Non-Urgent Care
Mental Health Services (non-emergency)
X Other conditions
Additional Information on Specific Conditions to be Treated: [Required if other conditions is selected] Most patients who will be treated are at a high risk for serious illness from COVID-19 as they have underlying chronic conditions <such as cardiometabolic diseases, Cancer depending on specific specialty practice etc.> and may be immunocompromised. Moreover, a majority of patients are over the age of 60 <Mention your patient demographics here>, increasing their risk of serious illness. Such patient populations must be protected from exposure to COVID-19, while still receiving quality care for their conditions, whether it involves a routine cardiology examination, a procedure, or post procedure follow-up.
If yes, please explain how using COVID-19 Telehealth Program funding to treat patients without COVID-19 symptoms or conditions would free up resources that will be used to treat COVID-19. (Required if yes) Digital triage through AI based chatbot and referral to telehealth visits, supports effective care management outside the hospital. This triage mechanism routes patients to remote patient monitoring program to monitor exposed, diagnosed and quarantined patients, in addition to general population health surveillance. These features enable patients who are not seriously ill to be managed outside the hospital setting, freeing valuable resources including hospital beds for severely ill COVID-19 patients and reducing the burden on health care personnel.
Additional Information Concerning Requested Services and Devices
What are your goals and objectives for use of the COVID-19 Telehealth Program Funding? The overall goal is to help better manage COVID and non COVID patients outside the hospital with a specific focus to provide care to underserved patient populations. Proper stratification of patients according for their condition and care needs coupled with effective management of a large number of patients outside the hospital will not only protect facilities from risk of infection but will also free up valuable hospital resources and workforce to treat more serious COVID-19 illnesses. Patients triaged outside the hospital and post-discharge are regularly monitored with Remote Patient Monitoring devices like pulse oximeters, connected thermometers and other devices. In addition, electronic outreach and knowledge dissemination is carried out in multiple languages in addition to English and Spanish, to ensure maximum coverage and keeping the population informed about COVID-19 and ensure their general health and wellness.
What is your timeline for deployment of the proposed service(s) or devices funded by the COVID-19 Telehealth Program? Based on the imminent need for telehealth services for both patients and healthcare workers alike, the service and/or product deployment can be activated in 4-5 days.
What factors/metrics will you use to help measure the impact of the services and devices funded by the COVID-19 Telehealth Program? The need for infection prevention and COVID 19 general information guidance is paramount in preventing and managing the spread of infection. Key metrics used to measure the impact of services will include factors such as Patient population outreach and triaged, number of telehealth visits, number of patients managed outside the hospital and resulting efficiency in bed management and workforce utilization helping to treat COVID-19 cases.
How has COVID-19 affected health care in your geographic area (e.g, county)? As of 4/__/2020, _____County has over ________confirmed cases with over _____confirmed deaths. The state of ______has over _____cases and over ______deaths. There is a dire need for more resources and better management of the COVID-19 outbreak.
Please provide additional information about the geographic area and population you serve. Does it have large underserved or low-income patient population? Have there been recent health care provider closures or other health care deficiencies? If so, please describe such factors (Optional) Customize according to your geographic area/facility/practice and the current situation
Do you plan to target the funding to high-risk and vulnerable patients?
X Yes
No
If so, please describe how. Telehealth and digital triage can prevent high risk and vulnerable patients from missing appointments and from being exposed. Electronic outreach features high risk population specific resources in their native languages and guides which can be disseminated to patients. As mentioned previously, this provider site treats an underserved patient population, with many patients suffering from chronic illnesses such as heart disease, with various comorbidities. Many patients are also over the age of 60. Such patients are at a high risk for serious COVID19 illness, and tools such as digital triage, telehealth, and electronic outreach are critical in providing them with quality care and preventing their exposure.
Please provide any additional information to support your application and request for funding (Optional)
Funding for an end-to-end solution which includes not just telehealth visits but an end-to-end connected care for patients will enable providers to rapidly scale their response to COVID-19 and help manage their high-risk patients, many of whom are underserved. With COVereD.Health, health systems and facilities can rapidly automate triage to address COVID specific needs, conduct telehealth visits, and monitor their population’s health, all within a single platform that could be deployed immediately. This platform would significantly free up hospital resources for seriously ill COVID patients, as well as provide improved quality of care and protection from exposure to virus for non COVID patients. This funding will be utilized in an area with a large underserved population, with many low-income patients. It will provide linguistically competent care, including answers to FAQs are resources to patients in their native languages. It will also enable telehealth visits, remote patient monitoring, and digital triage, all of which will enable healthcare providers to provide connected care services to patients at their homes in response to COVID-19. This funding will directly enable patients to be treated at home, preventing exposure to COVID-19 and freeing up valuable hospital beds.
Requested Funding Items
Total Amount of Funding Requested: $xxxx
Are you requesting funding for devices?
X Yes
No
How are the devices integral to patient care? Tablets and connected devices are necessary to enable telehealth and remote patient monitoring. RPM devices such as pulse oximeters are integral to monitor COVID patients post-discharge. Telehealth and RPM is also necessary for the non-COVID cardiac population in order to continue providing quality care to patients without the risk of exposure to COVID19.
Are the devices for patient use?
X Yes
No
Are the devices for the health care provider’s use?
X Yes
No
Category (Optional): Devices
Description of Service(s) and/or Device(s)(Optional) Pulse Oximeter, Connected thermometer and Blood Pressure Monitor with a central hub to collect and transmit data from all devices to the monitoring and surveillance dashboard
Quantity (for Devices)(Optional): ___RPM devices + Telehealth Services (___ provider seats)
Total One-Time Expense(Optional): $_____(Telehealth)+$____ Per Device kit = $_______
Date [Purchased or] To Be Purchased (Optional): April __, 2020
Total Monthly Expense (Optional): $__/Provider+$___ Per device kit per patient = $_____
Number of Months for Recurring Monthly Expenses (Optional): 3
3. Each HCP must obtain eligibility determination from the USAC
File FCC Form 460 - “RHC Universal Service Eligibility and Registration Form”
- Link to the form: https://rhc.usac.org/hcf/public/publicFindHcp.htm
- Enter email and zip code, and click New HCP
- Apply to “determine eligibility of an HCP site”
Form 460 Guides:
- Individual HCP Form 460 Guide:
- Consortium Form 460 Guide:
NOTE: Applicants that do not yet have an eligibility determination from USAC can still nonetheless file an application with the Commission for the COVID-19 Telehealth Program while their FCC Form 460 is pending with USAC.
Form 460 Cheat sheet https://know.rx.health/en/support/solutions/articles/48001077720
4. Register with System for Award Management (SAM)
NOTE: This part of the application may take up to 10 business days for registration to become active and an additional 24 hours before registration is available in other government systems
- Register at: https://www.sam.gov/SAM/
- What you need to register your business as a ‘New Entity’:
- DUNS number
- If you do not have a DUNS number already, you may apply for and receive a DUNS number in 1 day here
- Taxpayer Identification Number (TIN) or Employment Identification Number (EIN)
- Review your tax documents from the IRS (such as a 1099 or W-2 form) to find your Taxpayer Name.
- Bank’s routing number, account number and bank account type (i.e. checking or savings) to set up Electronic Funds Transfer
- DUNS number