Medical Billing Services

Provider Relief Funds – Post-Payment Reporting Requirements

The Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program (PPP) and Health Care Enhancement Act, allocated funds to reimburse eligible healthcare providers for healthcare-related expenses or lost revenues attributable to the coronavirus. Health Resources and Services Administration (HRSA) distributes these funds through the CARES Act PRF program. According to the update Provider Relief Fund (PRF), recipients who received one or more payments exceeding $10,000 in the aggregate of the data elements will be required to report as part of the post-payment reporting process.

CARES Act Provider Relief Fund

The Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act established the Provider Relief Fund. American workers, families, and the valiant healthcare providers in the combat against the COVID-19 outbreak are supported by The Provider Relief Funds.

The purpose of this $175 billion relief fund is to provide financial support to providers who are impacted by COVID-19 resulting in either necessary expenses or declines in revenue attributable to the coronavirus. Healthcare-related expenses or lost revenue attributable to COVID-19 can be supported using the Provider Relief Fund disbursements so long as the terms and conditions relevant to the particular allocation are met and the funds are utilized “to prepare for, prevent, and to counter coronavirus”.

Post-Payment Reporting Requirements

Beneficiaries of these funds agreed to Terms & Conditions requiring compliance with the reporting requirements as set out in the program instructions by the Secretary of Health and Human Services.

Secretary of HHS has determined that if any practice receives more than $150,000 total in funds from any of the COVID-19 targeted litigation (not just from the Provider Relief Fund) will need to submit reports and maintain documentation. Provider Relief Fund (PRF) recipients who received one or more payments exceeding $10,000 in the aggregate of the data elements would be required to report as part of the post-payment reporting process.

These reporting preconditions do not apply to the Rural Health Clinic Testing distribution or the Nursing Home Infection Control distribution. Reimbursements from the Health Resources & Services Administration (HRSA) Uninsured Program are excluded from these reporting requirements. However, in the future additional reporting might be announced for these payments.

Reporting Guidance on Use of Funds

Use of Provider Relief Fund payments by recipients will have to be reported by submitting the following information:

  • Healthcare-related expenses that are attributable to coronavirus that another source is not obligated to reimburse or has not reimbursed, which may include healthcare-related operating expenses (further defined within the data elements section below) or General and Administrative (G&A).
  • PRF payment amounts not fully expended on healthcare-related costs related to coronavirus are then added to lost revenues, depicted as a negative change in net operating income of patient care year-over-year (i.e., patient care revenue less patient care-related expenses for the Reporting Agency, described below that received funding), net of healthcare-related expenses attributable to coronavirus calculated under step 1.Up to the sum of their 2019 net benefit from healthcare-related sources, recipients can apply Provider Relief Fund payments to lost revenue. Provider Relief Fund amounts may be applied to lost earnings up to a net-zero gain/loss in 2020 by recipients who reported negative net operating income from patient care in 2019.

If by the end of the calendar year 2020, beneficiaries do not expend Provider Relief Fund funds, they will have an additional six months to use the remaining sums for expenditures due to coronavirus, but not reimbursed by any other sources, or to apply for lost revenues in a sum not to exceed the net gain of 2019. For example, the reporting period January 2021 – June 2021 will be matched to the same period in the year 2019.

About Medical Billers and Coders

We are catering to more than 40 specialties, Medical Billers and Coders (MBC) is proficient in handling services that range from revenue cycle management to ICD-10 testing solutions. The main goal of our organization is to assist physicians looking for billers and coders.

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Medical Billers and Coders

Catering to more than 40 specialties, Medical Billers and Coders (MBC) is proficient in handling services that range from revenue cycle management to ICD-10 testing solutions. The main goal of our organization is to assist physicians looking for billers and coders, at the same time help billing specialists looking for jobs, reach the right place.

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