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11/18/2020 - Updates on PPP Forgiveness
Kimberly Schwaiger, CPA and Matt Barczak, CPA, both of Rehmann, provided an excellent update on the Paycheck Protection Program (PPP). Kimberly began by reviewing the timeline on the PPP loan after the CARES Act that was enacted by Congress back on March 27th. Between April 3rd and April 16th, 1.7 million loans were processed, which used up the original $349 billion of funding. On April 24th a second round of funding was made available. On August 8th the Program expires with $134 billion left unused, even after more than 5 million loans were issued. On May 15th the Loan forgiveness application was released. On June 5th the PPP Flexibility Act was signed into law, allowing borrowers to wait up to 24 weeks from the loan origination date to complete the forgiveness application. Among the many qualifying uses include payroll costs (salaries, wages, commissions, etc), employer paid group health care, employer paid retirement, employer paid state and local taxes on employee compensation. There are three types of loan applications, all seemingly dependent on the amount of your PPP loan. As of October 1st there have been 96,000 forgiveness applications out of 5 million PPP loans). There is some legislation in the US Senate that would provide automatic forgiveness for loans less than $150,000, but that Bill has been “sitting” in committee since 6/30/2020. The income from the PPP is not taxable, but practices will not be able to deduct expenses related to the PPP forgiveness (i.e. payroll, retirement, health insurance, etc.). Matt Barczak, CPA spoke briefly on the HHS Provider Relief Funds that just showed up in many of our bank accounts. Initially thought to be funds that would not need to be repaid, HHS has subsequently determined that recipients will need to document what those funds were used for. There must be proof of loss of revenue and increased expenses due to COVID-19. Recipients need not begin reporting until January of 2021. Matt referred us to the HHS website and the FAQ for further information. There was a lot of really good information packed into a short time frame.

09/23/2020 - Revenue Cycle Management: Front Office Strategy
Mike Filkins of Central Professional Services presented virtually for our September Chapter Meeting. He provided some great information for collecting payment at the time of service. Patients have choices when it comes to their medical providers. You don’t want patients to leave or not return to your Practice because of a bad interaction. Provide a positive experience with every interaction, from scheduling to check out. Create a great patient experience and also set realistic expectations by ensuring intake paperwork includes clear and defined office policies and financial responsibilities. Your front desk staff are the first people that your patients are in contact with and they are critical to the success of the Practice. Asking patients for money is difficult for some staff and it is essential that they be trained to collect co-pays and deductibles BEFORE the patient leaves the office. Most patients will not ask if there is a co-pay or balance, they will simply leave and wait for a statement (or two or three) and even then they might not pay. Each statement costs, on average, $4.00 to send and often is not effective in prompting the patient to pay their bill, so collecting at the time of service is your best chance of obtaining those patient co-pays and deductibles. Mike’s list of “Things to Remember”: ~ This may be the last time the patient will be in the office ~ Verify all demographic information, including physical address, phone number, and social security number. This could be the difference of getting paid or not. ~ Statements cost money! Getting payment while the patient is in the office will always be more effective than sending statements to collect payment. Mike also recommends having a standardized script for your staff to refer to when asking the patient for money after seeing the physician. Be compassionate, but firm; help your patient understand their financial responsibility and how/if their insurance will pay any charges. As Mike so aptly stated, “Money is walking out the door everyday – make sure it is not because the consumer was not aware of or asked for payment”.

08/28/2020 - Michigan AutoNo-Fault Law Update
Big changes are happening with the Michigan No-Fault Auto laws. Since 1973 Michigan has been a no-fault state for auto accidents. Michigan no-fault insurance was/is the mandatory car insurance that was purchased for all Michigan drivers. If a driver was insurance in a car accident, the victim does not have to sue the at-fault driver for medical benefits or lost wages; your own auto insurance company pays regardless whether you were at-fault. The no-fault insurance laws required drivers to purchase unlimited PIP (personal injury protection) medical benefits. Those benefits cover any and all car accident related medical care and treatment for as much as and as long as reasonably necessary for the injured person’s care. Under the new auto reform law, drivers now have a choice whether they continue with unlimited PIP coverage or whether they would like to cap their coverage at $50,000, $250,000 or $500,000. For those Practices and physicians who provide services to auto injured patients, you know how expensive auto related expenses can be. For those drivers who opt to cap their PIP coverage, they potentially will use all of their PIP benefits in a short time. There will no longer be automatic PIP coverage for anyone driving your vehicle, only for the named insured, spouse and resident relative. These changes go in to effect when your policy renews on or after 7/2/2020. Next year will bring changes on how medical practices and physicians will be reimbursed by auto carriers. Currently there are no actual fee schedules for claims billed to auto carriers. Each claim is reviewed and for the most part paid at 100% or at what is considered “reasonable”. In the meantime, drivers are encouraged to discuss the new coverage options with their insurance agent and make informed decisions. It is anticipated that litigation will increase as drivers realize that the coverage they are used to is no longer in place and they have to “go after” the at-fault driver for benefits. Thank you to Pat Dewey of the Dewey Insurance Agency for sharing his knowledge on Michigan Auto Law Reform!



Jamie M Schichtel, CMM, HITCM-PP, CMA
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Jamie M Schichtel, CMM, HITCM-PP, CMA

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