Requests to Report Late Due to Extenuating Circumstances (Provider Relief Fund)

May 16, 2022
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Requests to Report Late Due to Extenuating Circumstances (Provider Relief Fund)

   

            Requests to Report Late Due to    Extenuating Circumstances (Provider Relief Fund)    


   Dear Provider:

   

Some providers have informed the Health Resources and    Services Administration (HRSA) that extenuating circumstances prevented    them from submitting a completed Provider Relief Fund (PRF) report in    Reporting Period 1. Today, HRSA is announcing an opportunity for providers    to submit a Request to Report Late Due to Extenuating    Circumstances for PRF Reporting Period 1 if one or more of the    extenuating circumstances described below apply.

   

From Monday, April 11 to Friday, April 22, 2022 at 11:59    p.m. ET, providers who did not submit their Reporting Period 1 report by    the deadline may request to submit a late Reporting Period 1 report, via a    DocuSign form, if certain extenuating circumstances exist.

   

During this process, a provider will chose which extenuating    circumstance(s) prevented them from meeting the reporting deadline. The    allowable reasons that constitute extenuating circumstances are as follows:    

   

       
  • Severe         illness or death         – a severe medical condition or death of a provider or key staff         member responsible for reporting hindered the organization’s ability         to complete the report during the Reporting Period.
    •    
  • Impacted         by natural disaster –         a natural disaster occurred during or in close proximity of the end of         the Reporting Period damaging the organization’s records or         information technology. 
    •    
  • Lack         of receipt of reporting communications – an incorrect email or mailing address on file         with HRSA prevented the organization from receiving instructions prior         to the Reporting Period deadline.
    •    
  • Failure         to click “submit”         – the organization registered and prepared a report in the PRF         Reporting Portal but failed to take the final step to click “submit”         prior to deadline.
    •    
  • Internal         miscommunication or error – internal miscommunication or error regarding the         individual who was authorized and expected to submit the report on         behalf of the organization and/or the registered point of contact in         the PRF Reporting Portal.
    •    
  •  Incomplete         Targeted Distribution payments – the organization’s parent entity completed all         General Distribution payments, but a Targeted Distribution(s) was not         reported on by the subsidiary.
    •    

   

Requests to Report Late Due to Extenuating Circumstances must    indicate and attest to a clear and concise explanation related to the    applicable extenuating circumstance; however, supporting documentation will    not be required. If HRSA approves the request, the organization will    receive a notification to proceed with completing the Reporting Period 1    report. Providers will have 10 days from the date they receive the    notification to submit a report in the PRF Reporting Portal.

   

Providers who plan to submit a Request to Report Late Due to    Extenuating Circumstances and have not registered in the PRF Reporting    Portal, should complete registration now. Registration instructions are on    the PRF Reporting Webpage.

   

Please note that providers will also have an opportunity to    submit a Request to Report Late Due to Extenuating Circumstances for    Reporting Period 2 if the extenuating circumstances are applicable.    Providers will receive a notification regarding the process to submit a    request for RP2 in the coming weeks.
   
   Where can I find more information?
   For additional information, please call the Provider Support Line at (866)    569-3522; for TTY dial 711. Hours of operation are 8 a.m. to 10 p.m. CT,    Monday through Friday.

   

Provider Relief Bureau
   Health Resources and Services Administration
   United States Department of Health and Human Services

     

         

 

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In-house Medical Billing

Initially, physician’s offices had a person in-house that handled everything having to do with billing for the practice. This person added to the overhead of the office – about 10 – 12% and handled everything from A-Z in the billing process. General knowledge of codes was all that was needed to ensure reimbursement from insurance companies as this was before managed care.

The beginning of managed care brought to the industry fee schedules, preferred provider contracts, the need for pre-authorizations and more. These changes meant a more intensive knowledge of medical codes was required as well as continuing to keep updated as codes were added and deleted.  These changes increased cost and time required to handle billing.

Outsourced to Medical Billing Companies

Initially, physician’s offices had a person in-house that handled everything having to do with billing for the practice. This person added to the overhead of the office – about 10 – 12% and handled everything from A-Z in the billing process. General knowledge of codes was all that was needed to ensure reimbursement from insurance companies as this was before managed care.

The beginning of managed care brought to the industry fee schedules, preferred provider contracts, the need for pre-authorizations and more. These changes meant a more intensive knowledge of medical codes was required as well as continuing to keep updated as codes were added and deleted.  These changes increased cost and time required to handle billing.

At PRM, we pride ourselves on exceptional expertise, dedicated specialists, and exceptional customer service so you can worry less and focus on patient care.

Our Complimentary Consultation is a discovery and feedback initiative built to help practices. You get one on one advice from our experts, plus a report for your practice to use, absolutely free for you.

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In-house Medical Billing

After listening to what clients were asking for, a more robust system was created that covered more than just standard medical billing. This full-cycle revenue management system saved doctors time and money by eliminating the need to have different people handling all other aspects. Revenue Cycle Management includes:

  • Insurance Eligibility – insurance verification and patient eligibility details checked two days ahead of a patient’s appointment ensuring 100% upfront collection.
  • Charge Posting – ensuring demographic information is entered in the system accurately helping to eliminate rejections or denial from the payer which can prolong the reimbursement turnaround time
  • Documentation Review – once visit notes are locked coding team retrieves a random sampling of the weekly visits to review and ensure proper guidelines were followed. We also provide education to the doctor and staff on their usage of CPT/ICD -10 to help them improve on future documentation
  • Claim Submission – claims are reviewed and scrubbed to ensure that all information in the claim is correct to help eliminate a denial
  • Denial Management – when payment for services is denied, we follow up with the insurance carrier to determine if it is a coding error or something else that has facilitated the denial. We complete appeals and add any supporting documentation submitted through your software
  • Payment Posting – critical to the health of your AR – insurance payments posted to patient accounts from EOB’s in the doctor’s system with a turnaround time of 24 to 48 hours. With daily payments accessible via the practice management system
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