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Hospital finance reports and dashboards: What to consider during a conversion

08.29.23

Whether you’ve been using your ERP for a while or you just launched a new system, are you making the most of the reporting functions within your system? What we’ve seen is that many clients are using incomplete reporting that does not meet their needs, or, worse, they’re performing manual work to make their financial reports and dashboards work for them.   

While it makes a lot of sense to start thinking about reporting capabilities during an ERP conversion, the details of reports and dashboards can often be lost during the intense implementation phase. The project team is likely focused on meeting their launch date with the basic functionality that was agreed to in the contract. While this is perfectly understandable, having custom reports and dashboards that are able to be systematically generated is an important and underused function of most new ERPs. These system generated reports can save an enormous amount of time and provide better analysis for your finance staff. 

So, how do you move forward with creating the financial reports and dashboards before, during, or after a system conversion? Here are some considerations:  

Plan your hospital financial dashboard needs before the conversion 

The best time to start thinking about your reports and dashboards is when you start planning for a new ERP system. By making it a priority early on, you can ensure that the vendor plans to either have the reports written to your specifications, or to train your staff on custom report writing in that software.  

Another reason to begin thinking about improving your financial reports during a conversion is that system conversions require behavioral changes. Since users will be learning new workflows for the new system, folding in processes for reports and dashboards will not seem like a big lift.   

Decide which custom reports and dashboards you need 

When choosing the reports to build, first consider the internal and regulatory reports that need to be produced frequently. Ask yourself and your team “What reports do I have now?” and also “What reports do I wish I had?” Consider reports that currently need manual manipulation to make them useful. It’s all too common to underestimate the report writing capabilities of the ERP system, and as a result the team ends up living with substandard output.  

Which reports should you build? Download our list of common reports and dashboard metrics.

Once you’ve decided on the reports and dashboards that you want, think about where the data needed for the reporting will be extracted from. Is it currently being collected? If not, you’ll need to think through how to start gathering that data and incorporate that into your ERP system workflow. 

Now that you’ve thought about common reports that you generate, go a step further to organize those reports by audience. Rather than trying to make one report fit different audience needs, you can build custom reports by audience to save time and frustration.  

For example, let’s take an income statement report. 

Maybe you have one report and, based on the need, you might manually format it for different uses or audiences. Taking your basic income statement report, you may create a version for board reporting, a version for internal leadership, a version for audit, a version for tax returns, and a version for budget prep. It may not seem like a huge time commitment for someone on your team to make these small formatting or data updates, but month after month, year after year, you’re investing significant time into something that the ERP system can easily do for you. Custom income statement reports can be programmed to format the reports exactly how you need them for each use and audience. 

Have a dedicated person on the project team focused on reports and staff training  

If possible, have a dedicated advocate on the ERP implementation team to think through how the new system will create reports. Ideally, the vendor will help this person learn how to write custom reports, and that person can train the appropriate staff on which reports to run and when. If this can’t be built into the project plan, you can purchase additional hours from the vendor post-go-live to help get reporting off the ground. 

Common reports for hospital financial reporting

As mentioned before, your reports will be based on entities and people you need to report to as well as what data you need internally. Based on our experience, here are some common reports that can be set up in your ERP software that will help you gain efficiency. 

For our full list of recommendations, download our Hospital Recommended Reports pdf

It’s never too late to gain efficiencies with custom dashboards 

If you’re not in a current conversion and are wondering how you might create custom dashboards and reports, you have options:  

If you have staff with programming acumen, your ERP system’s support center may be enough. You will likely need to gather a team to 1) determine what reports are needed 2) how to capture information that currently isn’t being captured 3) program the reports and 4) train staff in generating the new reports. 

At BerryDunn, our healthcare outsourced accounting team helps hospitals develop custom reports in various ERP systems. We have firsthand expertise in hospitals, and we understand what reports are commonly needed for which audiences. In many cases, we have also trained internal staff in report writing so they gain expertise in-house.  

Topics: ERP

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There’s a good chance that your organization is in the position of needing to do more with less under the strain of staffing constraints and competing initiatives. With fewer resources to work with, you’ll need to be persuasive to get the green light on new enterprise technology initiatives. To do that, you need to present decision makers with well-thought-out and targeted business cases that show your initiative will have impact and will be successful. Yet developing such a business case is no walk in the park. Perhaps because our firm has its roots in New England, we sometimes compare this process to leading a hiking trip into the woods—into the wild. 

Just as in hiking, success in developing a business case for a new initiative boils down to planning, preparation, and applying a few key concepts we’ve learned from our travels. 

Consensus is critical when planning new technology initiatives

Before you can start the hike, everyone has to agree on some fundamentals: 

Who's going? 

Where are we going? 

When do we go and for how long? 

Getting everyone to agree requires clear communication and, yes, even a little salesmanship: “Trust me. The bears aren’t bad this time of year.” The same principle applies in proposing new technology initiatives; making sure everyone has bought into the basic framework of the initiative is critical to success.

Although many hiking trips involve groups of people similar in age, ability, and whereabouts, for your business initiative you need to communicate with diverse groups of colleagues at every level of the organization. Gaining consensus among people who bring a wide variety of skills and perspectives to the project can be complex.

To gain consensus, consider the intended audiences of your message and target the content to what will work for them. It should provide enough information for executive-level stakeholders to quickly understand the initiative and the path forward. It should give people responsible for implementation or who will provide specific skills substantive information to implement the plan. And remember: one of the most common reasons projects struggle to meet their stated objectives (and why some projects never materialize to begin with), is a lack of sponsorship and buy-in. The goal of a business case is to gain buy-in before project initiation, so your sponsors will actively support the project during implementation. 

Set clear goals for your enterprise technology project 

It’s refreshing to take the first steps, to feel that initial sense of freedom as you set off down the trail. Yet few people truly enjoy wandering around aimlessly in the wilderness for an extended period of time. Hikers need goals, like reaching a mountain peak or seeing famous landmarks, or hiking a predetermined number of miles per day. And having a trail guide is key in meeting those goals. 

For a new initiative, clearly define goals and objectives, as well as pain points your organization wishes to address. This is critical to ensuring that the project’s sponsors and implementation team are all on the same page. Identifying specific benefits of completing your initiative can help people keep their “eyes on the prize” when the project feels like an uphill climb.

Timelines provide additional detail and direction—and demonstrate to decision makers that you have considered multiple facets of the project, including any constraints, resource limitations, or scheduling conflicts. Identifying best practices to incorporate throughout the initiative enhances the value of a business case proposition, and positions the organization for success. By leveraging lessons learned on previous projects, and planning for and mitigating risk, the organization will begin to clear the path for a successful endeavor. 

Don’t compromise on the right equipment

Hiking can be an expensive, time-consuming hobby. While the quality of your equipment and the accuracy of your maps are crucial, you can do things with limited resources if you’re careful. Taking the time to research and purchase the right equipment, (like the right hiking boots), keeps your fun expedition from becoming a tortuous slog. 

Similarly, in developing a business case for a new initiative, you need to make sure that you identify the right resources in the right areas. We all live with resource constraints of one sort or another. The process of identifying resources, particularly for funding and staffing the project, will lead to fewer surprises down the path. As many government employees know all too well, it is better to be thorough in the budget planning process than to return to authorizing sources for additional funding while midstream in a project. 

Consider your possible outcomes

You cannot be too singularly focused in the wild; weather conditions change quickly, unexpected opportunities reveal themselves, and being able to adapt quickly is absolutely necessary in order for everyone to come home safely. Sometimes, you should take the trail less traveled, rest in the random lean-to that you and your group stumble upon, or go for a refreshing dip in a lake. By focusing on more than just one single objective, it often leads to more enjoyable, safe, and successful excursions.

This type of outlook is necessary to build a business case for a new initiative. You may need to step back during your initial planning and consider the full impact of the process, including on those outside your organization. For example, you may begin to identify ways in which the initiative could benefit both internal and external stakeholders, and plan to move forward in a slightly new direction. Let’s say you’re building a business case for a new land management and permitting software system. Take time to consider that this system may benefit citizens, contractors, and other organizations that interact with your department. This new perspective can help you strengthen your business case. 

Expect teamwork

A group that doesn’t practice teamwork won’t last long in the wild. In order to facilitate and promote teamwork, it’s important to recognize the skills and contributions of each and every person. Some have a better sense of direction, while some can more easily start campfires. And if you find yourself fortunate enough to be joined by a truly experienced hiker, make sure that you listen to what they have to say.

Doing the hard work to present a business case for a new initiative may feel like a solitary action at times, but it’s not. Most likely, there are other people in your organization who see the value in the initiative. Recognize and utilize their skills in your planning. We also suggest working with an experienced advisor who can leverage best practices and lessons learned from similar projects. Their experience will help you anticipate potential resistance and develop and articulate the mitigation strategies necessary to gain support for your initiative.

If you have thoughts, concerns, or questions, contact our team. We love to discuss the potential and pitfalls of new initiatives, and can help prepare you to head out into the wild. We’d love to hear any parallels with hiking and wilderness adventuring that you have as well. Let us know! 

BerryDunn’s local government consulting team has the experience to lead technology planning initiatives and develop actionable plans that help you think strategically and improve service delivery. We partner with you, maintaining flexibility and open lines of communication to help ensure that your team has the resources it needs.

Our team has broad and deep experience partnering with local government clients across the country to modernize technology-based business transformation projects and the decision-making and planning efforts. Our expertise includes software system assessments/planning/procurement and implementation project management; operational, management, and staffing assessments; information security; cost allocation studies; and data management.  

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Into the wild: Building a business case for a new enterprise technology project

Read this if you are an IT Leader, CFO, COO, or other C-suite leader responsible for selecting a new system.

Vendor demonstrations are an important milestone in the vendor selection process for organizations assessing new software systems. Demonstrations allow you to validate what a vendor’s software is capable of, evaluate the usability with your own eyes, and confirm the fit to your organization’s objectives.

Pre-COVID-19, such demonstrations would generally take place in person. During the middle of COVID-19, remote demos were the only option. Today, organizations have choices between in-person or remote demos. Given staffing challenges and vendor schedules, remote demos can be more efficient and flexible and are a choice worth considering.

Here are some of the key success factors and lessons learned we found conducting and completing remote demonstrations.

  1. Prepare thoroughly for your remote software demo
    Establish a clear agenda, schedule, script, and plan prior to demonstrations. This helps keep everyone coordinated throughout the demos.
  2. Test the software vendor’s videoconference system
    It’s important to test the vendor’s videoconference solution from all locations prior to the demonstrations. We test with vendors a week in advance.
  3. Establish ground rules for the demo
    Establishing ground rules enhances meeting effectiveness, efficiency, and timeliness. For example, should questions be asked as they come up, or should participants wait until the speaker pauses? Should the chat function be utilized instead?
  4. Have clear roles by location
    Clear roles help to facilitate the demonstration. Designated timekeepers, scribes, and local facilitators help the demonstration go smoothly, and decrease communication issues.
  5. Be close to the microphone
    This is common sense, but when you’re in a virtual environment and you may not be on screen, be sure that you’re close to the microphone and are speaking clearly so everyone can hear you.
  6. Ask vendors to build in pauses to allow for questions
    Since vendors may not be able to see a hand raised, asking vendors to build specific pauses into their demonstrations allows space for questions to be asked easily. Consider designating a team member to monitor for hands raised and to interject so that a question can be asked in a timely manner.
  7. Do a virtual debrief
    At the end of each vendor demonstration, we have our own virtual meeting set up to facilitate a debrief. This allows us to capture the evaluation notes of the day prior to the next demo. Planning these in advance and having them on people’s calendars makes joining the meetings quick and seamless.

Observations and other lessons learned from remote vendor demos

After facilitating many remote software vendor demos, we’ve identified these lessons learned unique to virtual demos. 

Visibility is actually better with remote demos
Virtual demos allow everyone to see the demo on their own screen, which actually makes it easier to see than if you were doing the demo on-site. 

Different virtual platforms require orientation
We want vendors to use the tools they are accustomed to using, which means we need to use different products for different demonstrations. This is not insurmountable, but requires orientation to get used to their tools at the start of each demo.

Establishing the order in which team members provide feedback is useful
It’s helpful to establish an order in which participants speak and share their thoughts. This limits talking over each other and allows everyone to hear the thoughts of their peers clearly.

Staying engaged takes effort
Sitting all day on a remote demo and paying attention requires effort to stay engaged. Building in specific times for Q&A, calling on people by name, and designing the day with breaks can help people stay engaged all day.

Remote software demos can be highly successful, accomplish your goals, and help you meet critical timing milestones. We’ve found that post-COVID-19 when remote demos follow the guidelines above, they are often more efficient and engaging than if they had been conducted on-site. If you need assistance in implementing a healthcare IT solution, our team would be happy to help. Learn about our services. 

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Hosting efficient and engaging remote vendor demonstrations for software solutions

Do you know what would happen to your company if your CEO suddenly had to resign immediately for personal reasons? Or got seriously ill? Or worse, died? These scenarios, while rare, do happen, and many companies are not prepared. In fact, 45% of US companies do not have a contingency plan for CEO succession, according to a 2020 Harvard Business Review study.  

Do you have a plan for CEO succession? As a business owner, you may have an exit strategy in place for your company, but do you have a plan to bridge the leadership gap for you and each member of your leadership team? Does the plan include the kind of crises listed above? What would you do if your next-in-line left suddenly? 

Whether yours is a family-owned business, a company of equity partners, or a private company with a governing body, here are things to consider when you’re faced with a situation where your CEO has abruptly departed or has decided to step down.  

1. Get a plan in place. First, assess the situation and figure out your priorities. If there is already a plan for these types of circumstances, evaluate how much of it is applicable to this particular circumstance. For example, if the plan is for the stepping down or announced retirement of your CEO, but some other catastrophic event occurs, you may need to adjust key components and focus on immediate messaging rather than future positioning. If there is no plan, assign a small team to create one immediately. 

Make sure management, team leaders, and employees are aware and informed of your progress; this will help keep you organized and streamline communications. Management needs to take the lead and select a point person to document the process. Management also needs to take the lead in demeanor. Model your actions so employees can see the situation is being handled with care. Once a strategy is identified based on your priorities, draft a plan that includes what happens now, in the immediate future, and beyond. Include timetables so people know when decisions will be made.  

2. Communicate clearly, and often. In times of uncertainty, your employees will need as much specific information as you can give them. Knowing when they will hear from you, even if it is “we have nothing new to report” builds trust and keeps them vested and involved. By letting them know what your plan is, when they’ll receive another update, what to tell clients, and even what specifics you can give them (e.g., who will take over which CEO responsibility and for how long), you make them feel that they are important stakeholders, and not just bystanders. Stakeholders are more likely to be strong supporters during and after any transition that needs to take place. 

3. Pull in professional help. Depending on your resources, we recommend bringing in a professional to help you handle the situation at hand. At the very least, call in an objective opinion. You’ll need someone who can help you make decisions when emotions are running high. Bringing someone on board that can help you decipher what you have to work with and what your legal and other obligations may be, help rally your team, deal with the media, and manage emotions can be invaluable during a challenging time. Even if it’s temporary. 

4. Develop a timeline. Figure out how much time you have for the transition. For example, if your CEO is ill and will be stepping down in six months, you have time to update any existing exit strategy or succession plan you have in place. Things to include in the timeline: 

  • Who is taking over what responsibilities? 
  • How and what will be communicated to your company and stakeholders? 
  • How and what will be communicated to the market? 
  • How will you bring in the CEO's replacement, while helping the current CEO transition out of the organization? 

If you are in a crisis situation (e.g., your CEO has been suddenly forced out or asked to leave without a public explanation), you won’t have the luxury of time.  

Find out what other arrangements have been made in the past and update them as needed. Work with your PR firm to help with your change management and do the right things for all involved to salvage the company’s reputation. When handled correctly, crises don’t have to have a lasting negative impact on your business.   

5. Manage change effectively. When you’re under the gun to quickly make significant changes at the top, you need to understand how the changes may affect various parts of your company. While instinct may tell you to focus externally, don’t neglect your employees. Be as transparent as you possibly can be, present an action plan, ask for support, and get them involved in keeping the environment positive. Whether you bring in professionals or not, make sure you allow for questions, feedback, and even discord if challenging information is being revealed.  

6. Handle the media. Crisis rule #1 is making it clear who can, and who cannot, speak to the media. Assign a point person for all external inquiries and instruct employees to refer all reporter requests for comment to that point person. You absolutely do not want employees leaking sensitive information to the media. 
 
With your employees on board with the change management action plan, you can now focus on external communications and how you will present what is happening to the media. This is not completely under your control. Technology and social media changed the game in terms of speed and access to information to the public and transparency when it comes to corporate leadership. Present a message to the media quickly that coincides with your values as a company. If you are dealing with a scandal where public trust is involved and your CEO is stepping down, handling this effectively will take tact and most likely a team of professionals to help. 

Exit strategies are planning tools. Uncontrollable events occur and we don’t always get to follow our plan as we would have liked. Your organization can still be prepared and know what to do in an emergency situation or sudden crisis.  Executives move out of their roles every day, but how companies respond to these changes is reflective of the strategy in place to handle unexpected situations. Be as prepared as possible. Own your challenges. Stay accountable. 

BerryDunn can help whether you need extra assistance in your office during peak times or interim leadership support during periods of transition. We offer the expertise of a fully staffed accounting department for short-term assignments or long-term engagements―so you can focus on your business. Meet our interim assistance experts.

Article
Crisis averted: Why you need a CEO succession plan today

Read this if your CFO has recently departed, or if you're looking for a replacement.

With the post-Covid labor shortage, “the Great Resignation,” an aging workforce, and ongoing staffing concerns, almost every industry is facing challenges in hiring talented staff. To address these challenges, many organizations are hiring temporary or interim help—even for C-suite positions such as Chief Financial Officers (CFOs).

You may be thinking, “The CFO is a key business partner in advising and collaborating with the CEO and developing a long-term strategy for the organization; why would I hire a contractor to fill this most-important role?” Hiring an interim CFO may be a good option to consider in certain circumstances. Here are three situations where temporary help might be the best solution for your organization.

Your organization has grown

If your company has grown since you created your finance department, or your controller isn’t ready or suited for a promotion, bringing on an interim CFO can be a natural next step in your company’s evolution, without having to make a long-term commitment. It can allow you to take the time and fully understand what you need from the role — and what kind of person is the best fit for your company’s future.

BerryDunn's Kathy Parker, leader of the Boston-based Outsourced Accounting group, has worked with many companies to help them through periods of transition. "As companies grow, many need team members at various skill levels, which requires more money to pay for multiple full-time roles," she shared. "Obtaining interim CFO services allows a company to access different skill levels while paying a fraction of the cost. As the company grows, they can always scale its resources; the beauty of this model is the flexibility."

If your company is looking for greater financial skill or advice to expand into a new market, or turn around an underperforming division, you may want to bring on an outsourced CFO with a specific set of objectives and timeline in mind. You can bring someone on board to develop growth strategies, make course corrections, bring in new financing, and update operational processes, without necessarily needing to keep those skills in the organization once they finish their assignment. Your company benefits from this very specific skill set without the expense of having a talented but expensive resource on your permanent payroll.

Your CFO has resigned

The best-laid succession plans often go astray. If that’s the case when your CFO departs, your organization may need to outsource the CFO function to fill the gap. When your company loses the leader of company-wide financial functions, you may need to find someone who can come in with those skills and get right to work. While they may need guidance and support on specifics to your company, they should be able to adapt quickly and keep financial operations running smoothly. Articulating short-term goals and setting deadlines for naming a new CFO can help lay the foundation for a successful engagement.

You don’t have the budget for a full-time CFO

If your company is the right size to have a part-time CFO, outsourcing CFO functions can be less expensive than bringing on a full-time in-house CFO. Depending on your operational and financial rhythms, you may need the CFO role full-time in parts of the year, and not in others. Initially, an interim CFO can bring a new perspective from a professional who is coming in with fresh eyes and experience outside of your company.

After the immediate need or initial crisis passes, you can review your options. Once the temporary CFO’s agreement expires, you can bring someone new in depending on your needs, or keep the contract CFO in place by extending their assignment.

Considerations for hiring an interim CFO

Making the decision between hiring someone full-time or bringing in temporary contract help can be difficult. Although it oversimplifies the decision a bit, a good rule of thumb is: the more strategic the role will be, the more important it is that you have a long-term person in the job. CFOs can have a wide range of duties, including, but not limited to:

  • Financial risk management, including planning and record-keeping
  • Management of compliance and regulatory requirements
  • Creating and monitoring reliable control systems
  • Debt and equity financing
  • Financial reporting to the Board of Directors

If the focus is primarily overseeing the financial functions of the organization and/or developing a skilled finance department, you can rely — at least initially — on a CFO for hire.

Regardless of what you choose to do, your decision will have an impact on the financial health of your organization — from avoiding finance department dissatisfaction or turnover to capitalizing on new market opportunities. Getting outside advice or a more objective view may be an important part of making the right choice for your company.

BerryDunn can help whether you need extra assistance in your office during peak times or interim leadership support during periods of transition. We offer the expertise of a fully staffed accounting department for short-term assignments or long-term engagements―so you can focus on your business. Meet our interim assistance experts.

Article
Three reasons to consider hiring an interim CFO

Editor's note: read this if you are a CFO, controller, accountant, or business manager.

We auditors can be annoying, especially when we send multiple follow-up emails after being in the field for consecutive days. Over the years, we have worked with our clients to create best practices you can use to prepare for our arrival on site for year-end work. Time and time again these have proven to reduce follow-up requests and can help you and your organization get back to your day-to-day operations quickly. 

  1. Reconcile early and often to save time.
    Performing reconciliations to the general ledger for an entire year's worth of activity is a very time consuming process. Reconciling accounts on a monthly or quarterly basis will help identify potential variances or issues that need to be investigated; these potential variances and issues could be an underlying problem within the general ledger or control system that, if not addressed early, will require more time and resources at year-end. Accounts with significant activity (cash, accounts receivable, investments, fixed assets, accounts payable and accrued expenses and debt), should be reconciled on a monthly basis. Accounts with less activity (prepaids, other assets, accrued expenses, other liabilities and equity) can be reconciled on a different schedule.
  2. Scan the trial balance to avoid surprises.
    As auditors, one of the first procedures we perform is to scan the trial balance for year-over-year anomalies. This allows us to identify any significant irregularities that require immediate follow up. Does the year-over-year change make sense? Should this account be a debit balance or a credit balance? Are there any accounts with exactly the same balance as the prior year and should they have the same balance? By performing this task and answering these questions prior to year-end fieldwork, you will be able to reduce our follow up by providing explanations ahead of time or by making correcting entries in advance, if necessary. 
  3. Provide support to be proactive.
    On an annual basis, your organization may go through changes that will require you to provide us documented contractual support.  Such events may include new or a refinancing of debt, large fixed asset additions, new construction, renovations, or changes in ownership structure.  Gathering and providing the documentation for these events prior to fieldwork will help reduce auditor inquiries and will allow us to gain an understanding of the details of the transaction in advance of performing substantive audit procedures. 
  4. Utilize the schedule request to stay organized.
    Each member of your team should have a clear understanding of their role in preparing for year-end. Creating columns on the schedule request for responsibility, completion date and reviewer assigned will help maintain organization and help ensure all items are addressed and available prior to arrival of the audit team. 
  5. Be available to maximize efficiency. 
    It is important for key members of the team to be available during the scheduled time of the engagement.  Minimizing commitments outside of the audit engagement during on site fieldwork and having all year-end schedules prepared prior to our arrival will allow us to work more efficiently and effectively and help reduce follow up after fieldwork has been completed. 

Careful consideration and performance of these tasks will help your organization better prepare for the year-end audit engagement, reduce lingering auditor inquiries, and ultimately reduce the time your internal resources spend on the annual audit process. See you soon. 

Article
Save time and effort—our list of tips to prepare for year-end reporting

The COVID-19 emergency has caused CMS (Centers for Medicare & Medicaid Services) to expand eligibility for expedited payments to Medicare providers and suppliers for the duration of the public health emergency.

Accelerated payments have been available to providers/suppliers in the past due to a disruption in claims submission or claims processing, mainly due to natural disasters. Because of the COVID-19 public health emergency, CMS has expanded the accelerated payment program to provide necessary funds to eligible providers/suppliers who submit a request to their Medicare Administrative Contractor (MAC) and meet the required qualifications.

Eligibility requirements―Providers/suppliers who:

  1. Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/supplier’s request form,
  2. Are not in bankruptcy,
  3. Are not under active medical review or program integrity investigation, and
  4. Do not have any outstanding delinquent Medicare overpayments.

Amount of payment:
Eligible providers/suppliers will request a specific amount for an accelerated payment. Most providers can request up to 100% of the Medicare payment amount for a three-month period. Inpatient acute care hospitals and certain other hospitals can request up to 100% of the Medicare payment amount for a six-month period. Critical access hospitals (CAHs) can request up to 125% of the Medicare payment for a six-month period.

Processing time:
CMS has indicated that MACs will work to review and issue payment within seven calendar days of receiving the request.

Repayment, recoupment, and reconciliation:
The December 2020 Bipartisan-Bicameral Omnibus COVID Relief Deal revised the repayment, recoupment and reconciliation timeline on the Medicare Advanced and Accelerated Payment Program as identified below. 

Hospitals repayment, recoupment and reconciliation timeline 
Original Timeline 
Time from date of payment receipt  Recoupment & Repayment
120 days  No payments due 
121 - 365 days  Medicare claims reduced by 100% 
> 365 days provider may repay any balance due or be subject to an ~9.5% interest rate      Recoupment period ends - repayment of outstanding balance due 

Hospitals repayment, recoupment and reconciliation timeline 
Updated Timeline
Time from date of payment receipt  Recoupment & Repayment
1 year  No payments due 
11 months  Medicare claims reduced by 25% 
6 months  Medicare claims reduced by 50% 
> 29 months provider may repay any balance due or be subject to a 4% interest rate  Recoupment period ends - repayment of outstanding balance due 

Non-hospitals repayment, recoupment and reconciliation timeline
Original Timeline 
Time from date of payment receipt  Recoupment & Repayment
120 days  No payments due 
121 - 210 days Medicare claims reduced by 100% 
> 210 days provider may repay any balance due or be subject to an ~9.5% interest rate Recoupment period ends - repayment of outstanding balance due 

Non-hospitals repayment, recoupment and reconciliation timeline
Updated Timeline 
Time from date of payment receipt  Recoupment & Repayment
1 year No payments due 
11 months  Medicare claims reduced by 25% 
6 months Medicare claims reduced by 50% 
> 29 months provider may repay any balance due or be subject to a 4% interest rate  Recoupment period ends - outstanding balance due 

Application:
Applications for accelerated payments can be found on each MACs' website. CMS has established COVID-19 hotlines at each MAC that are operational Monday through Friday to assist providers with accelerated or advance payment concerns. Access your designated MACs' website here.

The MAC will review the application to ensure the eligibility requirements are met. The provider/supplier will be notified of approval or denial by mail or email. If the request is approved, the MAC will issue the accelerated payment within seven calendar days from the request.

When funding is approved, the requested amount is compared to a database with amounts calculated by Medicare and provides funding at the lessor of the two amounts. The current form allows the provider to request the maximum payment amount as calculated by CMS or a lesser specified amount.

We are here to help
If you have questions or need more information about your specific situation, please contact the healthcare consulting team. We’re here to help.

Article
Medicare Accelerated Payment Program

Read this if your company is seeking assistance under the PPP.

With additional funding for the PPP pending, we’re updating this blog post with more recent information.


This information is current as of April 21, 2020.

The Treasury Department has issued guidance and answers to Frequently Asked Questions that alters some of the original assumptions around PPP:

  1. At least 75% of the forgiven amount should be used for payroll (changed due to anticipated high demand for program)
  2. Repayment of non-forgiven amounts are now repaid over 2 years at 1.0% interest (not 2 years and 0.5% as previously stated or 10 years and 4% as in the CARES Act)

Although the “covered period” is February 15, 2020 to June 30, 2020, forgiveness of the loan is based on expenses (primarily payroll) during the eight-week period after the loan is received. Loan amounts should be disbursed within 10 calendar days of being approved.

Important to note:

  1. Questions around size:
    1. 500 employees. The SBA has clarified that it measures employees consistent with the existing 7(a) loan program guidance. See CFR Section 121.106 for details.
    2. The SBA has also clarified that if a business meets both tests in the “alternative size standard”, it qualifies to participate in the program
      1. Maximum tangible net worth of the business is not more than $15 million.
      2. Average net income after Federal income taxes for the two full fiscal years before the date of application is not more than $5 million. 
    3. If the existing SBA definition of a small business for your industry (found on SBA websites) has over 500 employees, your business may qualify if you meet that expanded definition. 
  2. The CARES Act states that loans taken from January 31, 2020, until “covered loans are made available may be refinanced as part of a covered loan.”
  3. People may want to tap into available credit now. If they are granted a covered loan (PPP loan), they can refinance. Given anticipated demand, it may take time to get the PPP loan processed.
  4. Participation in PPP (Section 1102 and 1106 of the CARES Act) precludes participation in the Employee Retention Credit (Section 2301).
  5. The IRS clarified that companies may still defer Payment of Employer Payroll Taxes (Section 2302) even if participating in PPP until a decision on forgiveness is reached by your lender. This is a change from our prior understanding.

Economic Injury Disaster Loans (EIDL)

EIDLs are available through the SBA and were expanded under section 1110 of the CARES Act. Eligible are businesses with 500 or fewer employees, including ESOPs, cooperatives, and others. Up to $2 million per loan. Up to 30 years to repay. Comes with an emergency advance (available within 3 days) of $10,000 that does not have to be repaid – even if your loan application is turned down. This $10,000 does not impact participation in other programs/sections of the CARES Act. Some portion of the EIDL may reduce your loan forgiveness under PPP, but receiving an EIDL does not preclude you from participating in the PPP.

From the Treasury: Small business PPP

The Paycheck Protection Program provides small businesses with funds to pay up to 8 weeks of payroll costs including benefits. Funds can also be used to pay interest on mortgages, rent, and utilities. More details at treasury.gov.

Fully forgiven

Funds are provided in the form of loans that will be fully forgiven when used for payroll costs, interest on mortgages, rent, and utilities (due to likely high subscription, at least 75% of the forgiven amount must have been used for payroll). Loan payments will also be deferred for six months. No collateral or personal guarantees are required. Neither the government nor lenders will charge small businesses any fees.

Must keep employees on the payroll—or rehire quickly

Forgiveness is based on the employer maintaining or quickly rehiring employees and maintaining salary levels. Forgiveness will be reduced if full-time headcount declines, or if salaries and wages decrease.

All small businesses eligible

Small businesses with 500 or fewer employees—including nonprofits, veterans organizations, tribal concerns, self-employed individuals, sole proprietorships, and independent contractors— are eligible. Businesses with more than 500 employees are eligible in certain industries.

When to apply

Starting April 3, 2020, small businesses and sole proprietorships can apply. Starting April 10, 2020, independent contractors and self-employed individuals can apply.

How to apply

You can apply through any existing SBA 7(a) lender or any federally insured depository institution, federally insured credit union, or Farm Credit System institution that is participating. Other regulated lenders will be available to make these loans once they are approved and enrolled in the program. You should consult with your local lender as to whether it is participating. All loans will have the same terms regardless of lender or borrower. Find a list of participating lenders and additional information and full terms at sba.gov.

The Paycheck Protection Program is implemented by the Small Business Administration with support from the Department of the Treasury. Lenders should also visit sba.gov or coronavirus.gov for more information.

BerryDunn COVID-19 resources

We’re here to help. If you have questions about the PPP, contact a BerryDunn professional.

Article
Updated: Funding for the Paycheck Protection Program (PPP)