CARES Act for Pediatricians Q&A

Finance
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21

3rd bullet down under Terms and conditions
Medicaid Relief Fund Payment Terms and Conditions

• The Recipient certifies that the Payment will only be used to prevent, prepare for, and
respond to coronavirus, and that the Payment shall reimburse the Recipient only for
health care related expenses or lost revenues that are attributable to coronavirus

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I have reason to believe folks who don’t get their TIN confirmed within an hour or two are hanging up on what they enter in the Group/Individual NPI/license section. You can call the provider help line 7 AM-10 PM Central M-F (866) 569-3522 to find out what happened.

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23

I just got off the phone with them and the representative stated it could take up to 24-48 hours to validate the TIN. I was asked to wait until tomorrow and if it was still in “processing” to reach back out and they would investigate the problem.
Not sure if this is the correct answer as it sounds like it should of been validated in a couple of hours, but I guess I’ll wait until tomorrow.

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Question for #13 lost revenues due to COVID-19 for March and April. Shouldn’t we use April and May, where we actually have significant loss due to COVID?
I am sure that all of us will agree there was not loss in revenue in March, since it all started March 16th and our reimbursements are 2-4 wks delayed.

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25

I’ve been working with the estimable @SKB on a document relating to this an all the other CARES questions. (Let’s be clear: she’s doing the work, I’m Court Jester.) She will be on the webinar on Thursday to discuss this, so TUNE IN.

We both grabbed data from our respective customer databases (PCC and OP) and here’s what I can tell you:

  • For roughly 85% of the market, just the losses for April will more than show a 2% loss. Remember, you’re not going to receive more than 2% of your annual revenue (based on the most recent tax return), so whether you lose $1m or $1, it doesn’t matter. You’re not going to get more than 2% of your revenue.

  • Most of the practices who don’t meet the 2% threshold have manageable circumstances…they’ve added physicians (hence their request for FTEs) or, for many, their practices have grown in size. PCC alone counted 14% of our client base as having been so new in 2019 that they couldn’t show a significant loss in 2020 - we all know their volume dropped compared to Jan/Feb, but it’s well up compared to last year.

  • I suspect that many of those who can’t show the 2% loss in revenue will easily show a significant increase in expenses.

Hold tight for more information on Thursday!

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Thank you Chip!! Can’t wait to hear more Thursday. I really appreciate the dedication to help and guidance through this time.

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Have been waiting 5 days (3 business days) for our TIN confirmation without hearing anything. Tried calling the number listed above and they said they didn’t see any errors and we should wait until it had been 3 more days to call back. Sounds like they’ve gotten busier and the turnaround is slower now!

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AAP is actively investigating this. You are NOT alone. We suspect that your TIN may not be listed in the list of Medicaid-credentialed TINs submitted by your state (not your fault, of course.) There’s also the chance that your NPI submission didn’t match what was expected

HHS indicated that practices that were not autoverified (i.e. click and you’re instantly validated) could pursue verification through an alternative process, but they have yet to publish what it is!

Again, AAP is all over this. They did NOT spend hours and hours nagging HHS folks to implement Medicaid payment relief only to have hard working pediatricians “glitch out.”

My best advice is to go ahead ad start preparing your application numbers now, so you can key them in once your TIN is validated.

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30 minutes after calling I got an email saying my TIN had been confirmed! Who knows if it was related or not?!?

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Someone from United is reading the forum and saw that @SKB was working on it and got scared!

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Completely agree. You beat me to the punch. I was searching the thread to see if anyone else was going to have a problem with pornographic chimpanzees from the wild. Always interesting when special interest have to get their section into a law.

Scanning through the attestation document, pediatricians should have no problem covering 2% of gross revenue as usable expense for COVID related additional cost and lost revenue.

Agree there will be some fine print and looks like some additional reporting requirements, but the grant would cover the additional work hours required.

Looks like I will have to look into Spider Monkeys instead and go ahead and apply.

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32

Hi All,

  1. I have two questions about the FTE stuff. I have an NP who bills under me, so I assume she is considered a non-primary FTE in field 28? However I have a LCSW who works independentaly, but is not listed in the types of “primary Provider” for field 27, where would you put her FTE?
  2. Field 25- total amount received from treasury SBA- does that include the EIDL grant? (ie the 1,000/fte that was advanced?)
  3. In several places it refers to “most recent federal income tax return” but in one place it says “most recent FILED federal income tax return” (caps mine) should we assume all should be most recent FILED? since we haven’t filed 2019 yet, that would make it 2018.
    Looking forward to Thursday’s call!
    Thanks, A
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  1. Both would be counted in Field 28.
  2. Yes.
  3. Yes.
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thank you!

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I was in the same boat. My TIN was in “processing” for 3 days. I called Monday and Tuesday and was told to wait. It FINALLY got past the processing stage, but now has an error and they’re looking into it…ugh!! More hurry up and wait, I guess…

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Our Pediatricians are part of a multispecialty group with Internal Medicine providers. As part of the first Cares Act, the Medicare providers received funds based on Medicare receipts. This left out the Pediatricians. Now, the Pediatricians are being denied, because the shared tax id received funds from Medicare. Any advice?

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There were two phases to the MediCARE distribution:
a) One was a flat fee based on your billed MediCARE revenue. Pediatricians for the most part don’t have a claim on these funds because we don’t accept much, if any, Medicare.
b) The second was a “2% of all receipts” distribution, very similar to what Pediatricians are now applying for. If your practice applied for this money, they included ALL their receipts, including the revenue YOU generated as a pediatrician.

Did your practice apply for, and receive, this second distribution, or just the automatic (first) Medicare distribution?

  • If your practice only took the first Medicare distribution and did not apply for the second, they left money on the table for all their clinicians (not just you.) The AAP does want to hear from pediatricians impacted, if this scenario applies to you, at covid-19@aap.org.
  • If your practice applied for and received the second distribution, then the revenue you produced as a pediatrician for payers OTHER than Medicare was counted in that work. What do your practice governance documents say about monies generated from the work you do?
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Hi Dr. Ramchas,

What report number did you run on ecW ebo to get your numbers? Thanks in advance.

Nonna

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Chip- so beyond the fact that our losses for April/May and March/April are both beyond that 2%, are you saying we HAVE to use March/April? Seems like so many things change down the line, that if i can show the months with my largest loss would prefer to do that.

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Correct, you have to use March/April - doubling or tripling your recorded losses won’t change the amount that the Feds distribute at this time.

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