Healthcare

Article Dean Dorton

The U.S. Department of Health and Human Services (HHS) is making $25.5 billion in new provider relief funding available to healthcare providers. The Health Resources and Services Administration (HRSA), an agency of HHS, administers the provider relief programs on behalf of HHS. HRSA is using a single application portal to make $8.5 billion in American Rescue Plan Act (ARP) Rural payments and $17 billion in Provider Relief Fund (PRF) Phase 4 General Distribution payments.

Providers must fall in to one of the following categories to be eligible:

a. Must have either directly billed, or owns (on the application date) an included subsidiary that has directly billed, their state/territory Medicaid program (fee-for service or managed care) or Children’s Health Insurance Program (CHIP) for health care-related services during the period of January 1, 2019 to December 31, 2020; or

b. Must be a dental service provider who has either directly billed, or owns (on the application date) an included subsidiary that has directly billed, health insurance companies or patients for oral health care-related services during the period of January 1, 2019 to December 31, 2020;

c. Must have either directly billed, or owns (on the application date) an included subsidiary that has directly billed, Medicare fee-for-service (Parts A and/or B) or Medicare Advantage (Part C) for health care-related services during the period of January 1, 2019 to December 31, 2020;

d. Must be a state-licensed/certified assisted living facility on or before December 31, 2020;

e. Must be a behavioral health provider who has either directly billed, or owns (on the application date) an included subsidiary that has directly billed, health insurance companies or patients for health care-related services during the period of January 1, 2019 to December 31, 2020;

f. Must have received a prior Targeted Distribution payment.

The application portal for Round 4 of provider relief funds opened this week. You can access it at the following website:

Application Portal

The deadline to complete the first step of the application process is no later than October 26, 2021.  Applications must undergo a number of validation checks before financial information is submitted so providers are encouraged to begin their application as soon as possible to ensure they are able to meet the deadline. Information on the documents and information needed to apply can be found in the resources following.

In order to streamline the application process and minimize administrative burdens, providers will apply for both programs in a single application, and HRSA will use existing Medicaid, Children’s Health Insurance Program (CHIP), and Medicare claims data in calculating portions of these payments.

A sample application form can be found here:

Sample Application Form

The payment methodology for Phase 4 payments can be found here:

Payment Methodology

In addition to this, HHS released a series of new FAQ’s related to the provider relief funds.  A complete and up to date list of all FAQ’s can be found here:

FAQ

Please let us know if we can help you with anything provider relief fund related.

Lance Mann, CPA, CFE, CGMA
Assurance Director
lmann@deandorton.com • 502.566.1005

Adam Shewmaker, FHFMA
Healthcare Consulting Director
ashewmaker@ddafhealthcare.com • 502.566.1054

Article Dean Dorton

The Health Resources and Services Administration (HRSA) announced two important updates last week related to Provider Relief Funds (PRF) and Reporting Requirements:

  • $8.5 billion for providers that serve rural patients under the Medicare, Medicaid or Children’s Health Insurance Program (CHIP), and
  • $17 billion “for a broad range of providers who can document revenue loss and expenses associated with the pandemic.”
  • Implemented in order to help providers comply with PRF reporting requirements
  • Although HHS will not initiate collection activities or enforcement actions during the grace period, providers will still be out of compliance if reporting is not submitted by September 30, 2021
If you have questions about these two updates, please reach out to us for more information.

Questions? Contact Us!

Article Dean Dorton

Last week we reported that the Health and Human Services (HHS) Provider Relief Fund (PRF) Reporting Portal is open. Recipients of Provider Relief Funds must report on their use of these funds received prior to June 30, 2020 by September 30, 2021.  Today, HHS released new guidance for the audit requirements for PRF spending and lost revenue.  As a reminder, below is a table describing the deadline for using your Provider Relief Funds (and more information regarding reporting can be found here):

Deadlines for Use of Funds

Payment Received Period (Payments Exceeding $10,000 in Aggregate Received) Deadline to Use Funds
Period 1 Payments received April 10, 2020 to June 30, 2020 June 30, 2021
Period 2 Payments received July 1, 2020 to December 31, 2020 December 31, 2021
Period 3 Payments received January 1, 2021 to June 30, 2021 June 30, 2022
Period 4 Payments received July 1, 2021 to December 31, 2021 December 31, 2022

Audit Requirements

The new guidance released today clarifies that entities with fiscal years ending June 30, 2021 will be the first entities required to include Provider Relief Funds on their Schedule of Expenditure of Federal Awards (SEFA) and thus, be subject to audit of these funds. Entities with other fiscal year ends will include some or all of their Provider Relief funds on their next fiscal year end.

For example, if you are a December 31, 2021 year end, then you will include all funds from Periods 1 and 2 (described above) in your SEFA and your December 31, 2022 SEFA will include periods 3 and 4. Below are the specific FAQs that released by HHS. 

When should Provider Relief Fund expenditures and/or lost revenue be reported on a nonfederal entity’s Schedule of Expenditures of Federal Awards (SEFA)? (Added 7/15/2021)

Non-federal entities will include Provider Relief Fund expenditures and/or lost revenues on their SEFAs for fiscal year ends (FYEs) ending on or after June 30, 2021. Please refer to the 2021 OMB Compliance Supplement for additional information.

How will a non-federal entity determine the amount of expenditures and/or lost revenues to report on its SEFA for FYEs ending on or after June 30, 2021? (Added 7/15/2021)

A non-federal entity’s SEFA reporting is linked to its report submissions to the Provider Relief Fund Reporting Portal. Therefore, the timing of SEFA reporting of Provider Relief Fund payments will be as follows:

  • For a FYE of June 30, 2021, and through FYEs of December 30, 2021, recipients are to report on the SEFA, the total expenditures and/or lost revenues from the Period 1 report submission to the Provider Relief Fund Reporting Portal.
  • For a FYE of December 31, 2021, and through FYEs of June 29, 2022, recipients are to report on the SEFA, the total expenditures and/or lost revenues from both the Period 1 and Period 2 report submissions to the PRF reporting porta Provider Relief Fund Reporting Portal l.
  • For FYEs on or after June 30, 2022, SEFA reporting guidance related to Period 3 and Period 4 will be provided at a later date.

As discussed in the FAQs above, we will need to wait for the FY2021 OMB Compliance Supplement to be released later this summer for more information.

Questions? Contact Us!

Article Dean Dorton

As of the morning of July 1, 2021, the Health and Human Services (HHS) Provider Relief Fund (PRF) Reporting Portal is open. There are a few new resources of the portal that may help you through the Provider Relief Fund reporting process, which are also linked below. Further guidance was released to provide more detailed information on how to use the reporting portal.

Additional resources:

Reporting Time Periods (Updates – June 2021)

Provider Relief Fund recipients are required to report in each Payment Received Period in which they received one or more payments exceeding, in the aggregate, $10,000, as indicated in the table. Reporting must be completed and submitted to Health Resources and Services Administration (HRSA) by the last date of the reporting time period. Provider Relief Fund recipients that do not report within the respective reporting time period are out of compliance with payment Terms and Conditions and funds may be subject to recoupment.

Payment Received Period (Payments Exceeding $10,000 in Aggregate Received) Reporting Time Period
Period 1 Payments received April 10, 2020 to June 30, 2020 July 1, 2021 to September 30, 2021
Period 2 Payments received July 1, 2020 to December 31, 2020 January 1, 2022 to March 31, 2022
Period 3 Payments received January 1, 2021 to June 30, 2021 July 1, 2022 to September 30, 2022
Period 4 Payments received July 1, 2021 to December 31, 2021 January 1, 2023 to March 31, 2023

LanceMann, CPA, CFE, CGMA 
Assurance Director
lmann@deandorton.com • 502.566.1005

Article Dean Dorton

On June 11, 2021, HHS issued a Press Release that announced the Provider Relief Fund (PRF) reporting portal will now be open on July 1, 2021. HHS also provided a new reporting matrix, which is included below. You’ll note that PRF distributions received subsequent to June 30, 2020, may be used during periods beyond the original June 30, 2021 deadline. HHS has also updated the Post Payment Reporting Requirements to address the use of SNF and Infection Control distributions as well as the FAQs related to the Portal.

This guidance could add complexity to your reporting process given the newly created reporting periods based on when payments were received. We will continue to analyze this guidance.

Period of Availability and Reporting Time Periods

The period of availability of funds and reporting time period applies to all past and future PRF payments.

Provider Relief Fund recipients must only use payments for eligible expenses, including services rendered, and lost revenues attributable to coronavirus before the deadline that corresponds to the relevant Payment Received Period. These deadlines are based on the date the payments are received, as indicated in the table below – all funds will be available for at least 12 months and a maximum of 18 months. The payment is considered received on the deposit date for automated clearing house (ACH) payments or the check cashed date. Providers must follow their basis of accounting (e.g., cash, accrual, or modified accrual) to determine expenses.

Deadlines for Use of Funds

Payment Received Period Deadline to Use Funds
Period 1 Payments received April 10, 2020 to June 30, 2020 June 30, 2021
Period 2 Payments received July 1, 2020 to December 31, 2020 December 31, 2021
Period 3 Payments received January 1, 2021 to June 30, 2021 June 30, 2022
Period 4 Payments received July 1, 2021 to December 31, 2021 December 31, 2022

Reporting Time Periods (Updates June 2021)

Provider Relief Fund recipients are required to report in each Payment Received Period in which they received one or more payments exceeding, in the aggregate, $10,000, as indicated in the table below. Reporting must be completed and submitted to HRSA by the last date of the reporting time period. Provider Relief Fund recipients that do not report within the respective reporting time period are out of compliance with payment Terms and Conditions and funds may be subject to recoupment.

Payment Received Period
(Payments Exceeding $10,000 in Aggregate Received)		 Reporting Time Period
Period 1 Payments received April 10, 2020 to June 30, 2020 July 1, 2021 to September 30, 2021
Period 2 Payments received July 1, 2020 to December 31, 2020 January 1, 2022 to March 31, 2022
Period 3 Payments received January 1, 2021 to June 30, 2021 July 1, 2022 to September 30, 2022
Period 4 Payments received July 1, 2021 to December 31, 2021 January 1, 2023 to March 31, 2023

Dean Dorton will continue to monitor the PRF frequently asked questions and the reporting portal and will send future updates as they are released.

LanceMann, CPA, CFE, CGMA 
Assurance Director
lmann@deandorton.com • 502.566.1005

Article Dean Dorton

An effective and patient-friendly customer service team is critical to ensuring a positive patient financial experience. With increased focus on pricing transparency and more knowledgeable consumers, it is the customer service unit within your organization that can greatly determine a patient’s overall financial experience.

These four key principles can help improve your customer service function.

  • Handling all patient complaints and billing concerns. Patients need someone knowledgeable who can help them navigate their statements, be empathetic, and address any concerns they may have about the experience they have had at the organization.
  • Delegating all correspondence and insurance remits. Customer service representatives can provide essential assistance to assigning specific correspondence and remits from insurance companies to the appropriate party.
  • Coordinate and monitor early out vendor. The customer service representatives are vital in monitoring patient statements being sent to the patient timely and in sequence.
  • Monitor and complete self-pay refunds. If a patient pays more than their responsibility, the customer service department can confirm these overpayments and complete a refund for the patient.

As you assess the efficacy of your patient financial experience, consider these key questions:

  1. Does your organization have a dedicated customer service unit and place a specific emphasis around the patient from end to end revenue cycle (scheduling through payment)?
  2. Does your organization have personnel whose main job function is answering phone calls from the patient and addressing their concerns?
  3. Do you consistently field complaints from patients on not receiving their statements timely, not understanding their bill, or feeling as their issue is not addressed?
  4. Does your organization offer tools to the patient that keeps them engaged in their care through an online patient portal or secure messaging system, so the patients can efficiently and effectively reach customer service staff members?

As organizations develop a holistic approach to treating patients, the customer service unit will be critical to addressing a patient’s concerns. This unit can potential lead to recurring patient volumes, increased patient collections, higher HCAHPS scores, less patient complaints, increased efficiency in revenue cycle processes, and risk mitigation. Our experienced healthcare team can aid in implementing a new customer service team and assessing other areas around improving a patient’s experience, as a whole. To learn more about Dean Dorton Healthcare Solutions, follow the link below:

Learn More

Chip Dalton, MHA, CPC-A, CRCR
Healthcare Senior Consultant
cdalton@ddafhealthcare.com • 859.425.7683