If your inbox looks anything like mine, you now know how every company you have ever given your email address to will be responding to COVID-19. All that aside, my goal here is not to provide yet another update email, but instead tangible, actionable information that you can use to improve and support your business in the immediate future. We all have challenging times ahead, but we at TAG would not be living up to our tagline if we did not step up and lean in to help you, our clients, get through this time. This email message is a read but contains several crucial items and strong information for you and your team. I would encourage you to read it completely and reference it.
Beyond the details below, I want to personally extend my time, my team’s lift, and TAG’s commitment to support you and your practice in the challenging short, and prosperous long-term. If it is a phone call, a question by email, whatever, we are here. As always, we appreciate your business. If you don’t thrive, we don’t exist.
Do I Stay Open?
This is a question you and your team have to answer for yourselves. Weighing your finances, your perception of perceived risks related to social distancing needs, as well as staff and patient safety. Although we can’t answer this question for you, here are a few policy changes we can share that we have come across:
Waive your cancellation policy for the immediate future – let your patients know that you want to help make their lives easier given the myriad of items that may be impacting their financial needs.
Help keep your waiting room clear – offer to text your clients via your patient engagement system as they wait in the car to assuage concerns over social distancing needs as well as keeping your waiting room clear if someone does not heed the standard messaging about self-quarantine recommendations.
Talk to your HR Team – Plan ahead. There are options if you do need to go into a “hibernation mode” that will allow both your business and staff to have their needs met as best as possible in a difficult situation. we leverage a PEO model and G&A Partners as our support structure. If you have questions, please contact Dave Willis at email@example.com.
Evaluate Patient Screening and Communication
Leverage Patient Engagement Systems
Implement/Update your appointment reminders – Make sure patients understand if you are open or not and what protocol changes have taken place.
Customize communications across patient-base – Get communications out to ALL your patients so they hear your message, understand what is changing, how it impacts them, and why you are making the changes.
Customized pre-screening workflows – Build-in customized messaging surveys to automate the pre-screening process before your patients hit your door or the phones.
Update your website – Keep your message consistent across communication channels and easily visible. How does this help you and your practice?
Shows your patients you are ahead of the game and on yours – you have a crisis plan.
Reduces call surges by shifting communication to messaging – saves you and your staff TIME.
Keeps you, your staff and your patients safe by triaging without direct contact.
How do I get started?
How do I implement telemedicine into my practice?
By leveraging technology that allows for synchronous telemedicine (think video versus picture review) in place of in-person patient visits and/or in lieu of:
Consider building a cash-pay and traditional reimbursement model.
Message availability of the technology and concentrate on reacting to the current situation as a leader in the healthcare community.
Is this payable by insurance?
The landscape and legislation are changing daily. The government has indicated that they will be relaxing telemedicine regulations in the coming weeks, allowing for expanded AND payable utilization of the technology.
Specifically, the originating-site clause may be waived and the technical requirements may be relaxed as well. This means patients can call in from anywhere rather than qualified health sites using computers or even smartphones.
The biggest question mark, however, is whether these guidelines will be extended beyond the treatment of COVID19. Current written documentation alludes to treatment of COVID-19 being the rationale for loosening guidelines but does NOT specifically state that these regulatory changes only apply to said treatment or that other treatments are excluded.
Please keep in mind that this should be considered a piece of the larger financial puzzle of bridging your cash flow needs through patient care lanes/volume/treatment options. Your practice is only dependent on E/M visits to a degree. Take that current percentage and decrease it from there. Plan for a potential complete drop-off of revenue in other areas. Telemedicine is a powerful and necessary step in contingency planning.
Should I proceed with telemedicine?
Telemedicine will absolutely provide a value-add to your patients, meeting the current need for social distancing, while preparing you for a future that will increasingly demand convenience without sacrificing quality of care. It will also serve as a means of patient retention, bridging your relationship and revenue opportunities until we do return to the status quo in terms of freedom of movement.
If you are able to feasibly cost-contain, cashflow plan, and map out your path for the next three months, utilizing telemedicine is a great opportunity for the immediate, as well as distant future. If you have not assessed your cash position, this should not be your top priority.
How do I get set-up?
If your practice management system has an integrated telemedicine option, fantastic, use it. Symplast and Remedly have established tools already embedded, which are quite strong. ModMed seems to be pivoting to provide a solution immediately. Nextech also has a an integrated partner (firstname.lastname@example.org) if you are interested. Be sure to see what your software has available.
That said, the Auctus Group has particularly chosen to partner with Rezilient, a technology platform that will not only offer our clients a fast, efficient, and cost-effective solution for their immediate telemedicine needs, but also provide our clients a videoconferencing solution that will seamlessly integrate into future offerings, such as remote robotic physical exams and ambient, automated clinical documentation for both in-person and remote visits.
To learn more and get signed up, please contact Danish Nagda, MD, MBA at email@example.com. He can also be reached at 630-362-7392.
Financial Breathing Room
The reality here is that we may follow Europe and enter a full shutdown. So plan for it. The best practice is always to keep 2-3 months of expenses in reserves and a line of credit available for any business. The reality is, we don’t always follow this rule of thumb or simply may not be able to. Messaging, telederm, and operations are all incredibly important, but we need to keep the doors open first and foremost.
SBA Disaster Relief – Last year, the SBA issued 23B in funding to small businesses across the US. An additional 50B in funding has been suggested for release (up to 2B/loan) and sits with the Senate this week to pass into law. Once approved, state governments must issue a declaration of emergency and outline requirements for relief status. Thus far it appears only Texas has done so, and the relief funds are not yet available. The situation changes daily, but it appears release may occur this week. To check and see if your state/county has issued the declaration please access the search system here. As we learn more about who is eligible and how the SBA ascertains how much a business is eligible for, we will keep you updated.
Relaxed licensing requirements – Many states are relaxing licensing and credentialing requirements to allow physicians to expedite the process of joining. This may be leveraged as an ancillary revenue stream in the event of a slow down in your private practice.
TAG Loan Partners – Look to bring in additional capital from traditional methods. Most everyone has a banking relationship, which is the first place to look, but we have some unique relationships with vendors you may access for capital needs:
Bank of America – We all knot the bank, but not everyone is aware of their proclivity to be more aggressive with lending in the healthcare space. Contact Dietgar Delleg VP of Practice Solutions – firstname.lastname@example.org.
MMP Capital (https://www.mmpcapital.com/) – Working with many laser and asset companies in the aesthetic space, they understand medical and will push working capital loans. Contact Sean Etherson – email@example.com
Lendeavor (https://www.lendeavor.com/) – Medical-specific loan resource, tech leveraged, and strong in the market. I know the executive team quite well and can personally vouch for them. Lendeavor does not currently offer working capital loans, but with fantastic rates and fastest turn around on the market, they are your best option for a refi with a potential working capital cushion. Contact Joseph Merrill – firstname.lastname@example.org.
What we are doing at The Auctus Group
First and foremost, we aren’t going anywhere and we have moved swiftly this weekend to prepare ourselves for your needs. Here is how we plan to shift our priorities based upon the COVID- 19 pandemic.
AR concentration – Every hand we had entering charges and coding goes right to your AR. We are not planning on downsizing at this time. This means more people kicking and screaming at your insurance carriers more frequently and louder. We want to supplement any charge drop-off with additional revenue from your aged receivables.
Update our clients on industry reactivity – Things are going to change every single day for the coming weeks. We will stay on top of regulatory changes, opportunities, outages and an outline of how each change impacts our clients. Expect weekly updates at minimum from us.
Strategic planning session – It is of the utmost importance that you are prepared strategically to weather this storm. To that end, I am offering a free conference call to every single client to assist with business and cashflow planning. No consulting fee. No charge. Just you and I sitting down with your team to hammer out how we all get through this together. Part of our commitment to drive value to our clients as a priority over revenue.
Lastly, because we understand many of our clients will have any number of questions, we have restructured our entire company to accommodate our clients’ anticipated needs.
We have ceased 100% of our internal operations projects and refocused our operations team on client support. We have some rockstars, and we’re giving them to you. Maria Lotito, Director of Operations and David DePino, Director of Business Process, will both be available for our client base as well as reaching out proactively to assist and plan how we can assist you.
We are refocusing our entire billing team on your AR, reallocating their time as charge volume drops, headed up by our Director of Billing, Jillian Sherwood. We are also leveraging our operations team to handle communications to free up additional time for our billers to hit that AR.
We are anticipating drop-offs in patient inquiries and authorizations requests, so we will be refocusing these teams on your billing/AR needs as well. All. Hands. On. Deck. We are anticipating a delay in responsiveness from payers for contracting and credentialing needs, so Rachele Maue, our Director of Contracting, will be taking the lead on our research team to keep you abreast of every development.
We don’t anticipate the months ahead to be easy, but we plan on making them easier for you by coming prepared, with a plan, and operating from a place of confidence/action.
Thank you, as always, for your business and we look forward to seeing you on the other side of this,
John Gwin, CEO