Streamlining the Process for Relief Funds

The Biden-Harris Administration made $25.5 billion in new funding available for healthcare providers affected by the COVID-19 pandemic. HHS announced availability of the funding, which includes:

  • $8.5 billion in American Rescue Plan (ARP) resources for providers who serve rural Medicaid, Children’s Health Insurance Program (CHIP), or Medicare patients
  • An additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers who can document losses and expenses associated with the pandemic

Unspent Funds and Reconsiderations

The Washington Post made public a letter to HHS Secretary Xavier Becerra, that reads, tens of billions of dollars in pandemic aid for hospitals and nursing homes not distributed. The following remains unspent:

  • $44 billion from a Provider Relief Fund (PRF) created last year
  • $8.5 billion Congress allotted in March for American Rescue Plan (ARP) funding in rural areas

In addition, providers who believe their PRF Phase 3 payment was not calculated correctly have an opportunity to request a reconsideration of Phase 3 funding. There is also Phase 4 payment availability. The Health Resources and Service Administration (HRSA) has opened the portal for healthcare providers to apply for part of the billions in relief funds.

There are Deadlines

Time is running out on some of the deadlines to apply and use the funds. $25.5 billion in Provider Relief Fund & American Rescue Plan rural funding is now available but applications must be submitted by October 26, 2021. According to HHS, providers who received more than $10,000 in aggregate funds from the Provider Relief Fund (PRF) between April 10, 2020 and June 30, 2020, have until the end of the month to use the funds.

To complicate things a bit more, HHS extended the deadline to use the funds for providers who received at least $10,000 in total after June 30, 2020. If providers received the funds between July 1, 2020 and December 31, 2020 they have until the end of the year to use the funds, while providers who received the funds between January 1, 2021 to June 20, 2021 have until June 30, 2022.

There is Oversight and Enforcement of Use

Providers receiving payments from the Provider Relief Fund must comply with the terms and conditions and applicable legal requirements.

This is where automation shines, by incorporating and streamlining the rules-based process and relieving the administrative burden on providers, hospitals, and health systems. Automation allows the hospital and/or provider organization to review the patient information, ensure all of the information being added is accurate and complete, and submits the required data via the HRSA web portals.

Automation Eliminates Up To 20 Time-Consuming, Manual Steps Including:

  • Review patient information for coverage and eligibility in the EHR
  • Captures the necessary information for claims submission
  • Navigates to multiple web portals
  • Applies for the Temporary ID
  • Sends documentation and/or notes back to the EHR
  • Ensures timely filing and submits claims for payment

Automation eliminates these time-consuming and manual steps between the EHR, payer authorization portals, and the HRSA program portals. Automation ensures accuracy, which is an important factor of the HRSA and HHS programs. If a claim is submitted with a potential error, the claim is returned to the provider, delaying the reimbursement process and creating the need to repeat the claims processing steps.

How to Streamline the Process and What to Expect

Don’t leave money on the table. At Boston Software Systems we can implement a process quickly, so that you can take advantage of every reimbursement that you are entitled to receive.

  • Save hundreds of hours of manual data entry
  • Send notes and information to the EHR
  • Speed HRSA claims for reimbursement
  • Eliminate overwhelming administrative burden on staff

Why Boston Software Systems?

Give us a call. We have worked with multiple client hospitals on the COVID-19 claims reimbursement process. KLAS reviewed and customer validated, we can have this process deployed quickly and without disruption to people or existing infrastructure.

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