Robin R Varghese, PT.
What Small Therapy Business Needs to Know & Do Now During the Pandemic COVID19 & CARES Act (S.3548)
Updated: Mar 30, 2020
1. Employee and business management based on 2 trillion CARES Act (S.3548) passed by the Government. Each business needs to figure out what kind or how much of Business SBA Loan is each company eligible for under this Stimulus Bill, what all expenses can this be used to cover, how much of this loan can be written of under 'Forgivable loan' terms under this Bill. Small Business Disaster Loan or COVID19 related Loan Applications can be submitted online here: https://www.sba.gov/page/disaster-loan-applications. To find how much each business may qualify, the rough estimate is that each company needs find their average monthly expenses including Payroll, lease/rent, loans etc and multiply by 4. A Business needs to maintain at least 75% of the Full Time Employee (FTE) pay after taking the loan for a certain period for the loan to be considered 'Forgivable'. Loans are available in a maximum amount of $2 million, carry an interest rate of 3.75 percent if they are not considered forgivable and have a maximum term of 30 years. The good thing is that there is 'No' requirement for personal guarantees on loans under $200,000. As long as the Business was in operation on January 31, 2020, it will be eligible. The Paycheck Protection Program authorized by the CARES Act makes loans of up to $10 million available to certain qualified small businesses. These loans are intended to be forgivable if the borrower maintains employees and otherwise complies with the CARES Act.
A qualified small businesses is a business that:
Does not have more than 500 employees or the maximum number of employees specified in the current SBA size standards, whichever is greater; or
If the business has more than one location and has more than 500 employees, does not have more than 500 employees at any one location and the business' primary NAICS code starts with "72" (Accommodation and Food Service); or
Is a franchisee holding a franchise listed on the SBA's registry of approved franchise agreements; or
Has received financing from a Small Business Investment Corporation.
Sole proprietorships and self-employed individuals may qualify under this program.
The maximum amount of the loan is set by formula (average monthly payroll prior to the COVID-19 pandemic times 2.5 plus the amount of any other debt approved for refinancing, including any debt incurred as a result of COVID-19 under the EIDL Program), subject to a maximum of $10 million.
2. Initiate E-visits which can be done only by Licensed PTs, OTs, or SLPs and for existing patients. There are 3 different codes that can be billed based on the time spend ranging from 5 to 30 mins and each code can be only billed once in 7 days. CMS describes e-visits as “non face-to-face patient-initiated digital communications that require a clinical decision that otherwise typically would have been provided in the office.” The code descriptors for the HCPSC codes related to e-visits suggest that the codes are intended to cover short-term (up to seven days) assessments and management activities that are conducted online or via some other digital platform and include any associated clinical decision-making. Reimbursement ranges from 13 to 26$ based on the codes billed. Please see APTA webpage for detailed information: http://www.apta.org/PTinMotion/News/2020/03/18/E-VisitFAQs/
3. Initiate Telehealth visits: Most insurance carriers have opened up Telehealth for therapists. We do have our concerns regarding how effective this is regarding patient care, future of these affecting our reimbursement for these same codes and much more. But there are businesses who have concerns regarding Post surgical patients or essential care patients, or even some of them regarding loss of revenue from no patients being seen. For them, Telehealth maybe an option.
4. Work On AR especially 30 day plus ones. This should help businesses to help bring in some funds which was stuck up, especially when these business do not have any current claims to be generated. Most Clinics on an average has payments coming in a month from 50% of current month's claims, 30% for claims submitted a month back, 10-15% from claims submitted 2 months back(60-90 days), 5-10% from 90-120 days old claims and 2-5% from 120 days or older claims.
Hope this helps.
Robin R Varghese, PT
Valley Healing Hands LLC.