83: HHS Enhanced Provider Relief Fund: What It Means for DSO Leaders

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Alrighty. Hello everyone and welcome to another episode of DSO Secrets. I'm your fearless host, Emmett Scott, and I have got a motley crew here with me today. We won't go through introductions right here at the beginning, but, but we're all addressing a critical component right now, which is the HHS funds that have now expanded from just being for Medicaid providers in dentistry and throughout other healthcare stacks and industries to now all dentists. And I've invited Chris Badgley, who's the executive director with Adso. And Chris, thank you so much for being on. And you've been on the front lines of this, like literally the front lines. So I appreciate, I kind of wanted to hear a little bit about what was happening on the back end to make this happen because even today I still get posts from people saying now this is just for Medicaid providers. Right. And you did a lot of work with your team to make that expanded out. So anyway, first of all, Chris, welcome to the show.

Thanks, Emmett. It's my pleasure and I'm really glad to be part of this group and this panel of Ben Preston and Ken and yourself. It has been a very, very interesting process. And although I've been involved in health care for well over the past 30 years, now this, this was a unique situation and it's unique because dentistry is unique within healthcare. Certainly we want to expand that over time and that may be part of another program. But if everybody looks at the CARES act, the CARES act passed with a $150 billion set aside under the Health and Human Services HHS Provider Relief Fund. And the purpose of the fund and all the money in there was to give relief to healthcare providers, whether they be hospitals, medical providers, dental providers, long term care, nursing home providers, et cetera, to give them a grant, not a loan, but a grant to replace some of the revenue that they might have lost being shut down during the height of the pandemic. We know that dental offices have been opening up for the last several weeks. But dental, as I'm sure all of you who are watching this webcast know, dental was probably impacted more than any other provider group. But the first rollout, the non hospital type rollout, was done for Medicare providers. And what they did was that they, the government use the Medicare data file that they use for reimbursement and to identify active practices to literally push out 2% of annual revenue to Medicare providers. Well, most dental offices don't accept Medicare. There's no Medicare Advantage.

And they started with Medicare for, I mean this is a logistics issue in some ways, right, because they had a desire to support a lot of health care. But why did they, they started with Medicare because of their, their ability to have that data. Basically, yeah.

HHS within, within HHS already had the list of valid active practices that accepted Medicare. So they could match the applicant with the PRAC with an active practice and tie that to the taxpayer identification number or the employer identification number T I N ein and so that's why. And again they pushed that money out almost immediately because they had the match and I knew what was a valid practice so they could minimize the amount of fraud and abuse. What happened then was we entered into discussions with them early and they were saying hhs and they were saying, well look, we also can get the Medicaid file from states because Medicaid is a state administered program. But states could supply that data set to HHS and then HHS could marry valid active Medicaid tins and eins to applicants. And so that's why the next tranche of money within the $150 billion fund was for Medicaid chip providers.

Interesting.

Once the application started coming in in HHS and hrsa, which is the agency within hhs, they used to disperse the funds. They actually contract with UnitedHealth Group to be the administrator of the program and do all the back end stuff. So HRSA had the, got the file, Medicaid files from the states, data sets, unactive practices. And so then they opened up the enhanced portal for applicants to come in if you had an active Medicaid provider number. So again you could apply. The missing piece was, okay, if you have a dental practice that doesn't accept Medicare, doesn't accept Medicaid, is either cash or self pay only, or a mix of cash, self pay and insurance. How do we match active practices to applicants to make sure that somebody just doesn't get a taxpayer identification number, fill out an application, say that they have $600,000 in annual gross patient revenue. They get 2% of that and the money is electronically transferred to a bank in a Caymans. They were really, really concerned about not making the mistake of paying fraudulent applicants and then having to chase that money because it doesn't look good from the government side. And look, I get that. So what they did originally was they reached out to one of the largest insurance providers, insurance carriers, Delta Dental. And they brought in house the Delta Dental data set. But we had talked to them and said, look, Delta is a large player in the market. They probably have over 50% of the insurance payments. But you're going to miss a large part still of the general dental offices that don't accept, for whatever reason, Delta Dental. And they said, okay, so what do we use then? What do we use as a data set? So I won't mention the name of the organization because I'm not authorized to do so. But we recommended a large strategic database supplier and analyzer that has over 3 billion individual claims, procedure claims. They have the data within those claims of over 80% of the insurance carriers in the United States. And in any six month period of time, they process at least one claim for 93% of all active dental practices.

Chris, I just want to stop you for a second because I think with everything that's been going on government wise, we're, you know, kind of understanding how some of this back end happens, I think is helpful for people. So when you have an association like Adso, a lot of times the blocking and tackling and solutions that you're providing for government, sometimes it's education and helping them understand the industry. In this situation, it was really like tactical administrative logistic type issue, right? How do we get money to the right people? And this is where you need an organization. When people say, why do we have associations out there? Because none of us individually would have been able to take this on. I mean, this was months of activity to solve this, right? I mean, we would have loved for it to be one week, but getting to the right people, to the right committees, all of that. And as much as we'd like to believe that we're the biggest priority of all these legislators, we're not. And so you have to have people in there who are constantly moving you back up on the stack, saying, hey, this hasn't happened yet. This needs to get solved, et cetera. And that's basically what Adso team was constantly doing.

Yeah, and Emmett, yes, that's correct. But, and Emmett, to this point, we did have quite A few champions, both in the legislative end in the House and the Senate. There's five dentists who are members of the House of Representative, U.S. house of Representatives. There aren't any senators. But we also had this isn't related to the HHS Provider Relief Fund, but we also worked earlier on on the paycheck protection program, the ppp, and working with especially Senator Rubio from Florida, who's the chair of the Small Business Committee, to work through some of the issues affecting DSOs and their supported practices on the PPP side. So this was a kind of continuation of that discussion. But even White House Chief of Staff Mark Meadows got involved and said, look, we got to solve this problem for dentists. My dentist is wondering where their relief is. So he goes, we got to solve this problem. So he was very helpful as well. And there are countless others within the administration, both within HHS and the White House that helped push this forward. But again, Emma, to your point, the real hang up was how does HHS and HRSA get a robust data set that's verifiable, that can match active dental practices with a third party validator so that when an applicant comes in says here's 2% of my or here's my gross annual revenue that HRSA can push out through again UnitedHealth Group on an ACH on an electronic basis directly into an account, 2% of gross annual patient revenue. So it took a long time because they wanted to get it right. I believe that they have it right now for those of you who may be listening, that say, you know, look at the practices I support are self paying cash pay, they're still not going to be in that data set. We know that that is a smaller subset of the general dental distribution. And HHS and HRSA is probably going to do a little more one on one, maybe even phone call type outreach to make sure that a practice is open at a given phone number in a given state and it can match it that way. But what they wanted to do in our discussions with them were to how do they minimize that? Because it's very expensive to have a phone bank of people calling to see if it's an active valid practice. So we worked through all of that and a couple weeks ago, just a little over under a week ago, on the 10th, the General Dental distribution went live and everybody who has an active dental practice should apply for the money again. It's a grant, not a loan. It's 2% of your annual patient revenue. If you have a valid taxpayer ID number or Employer identification number that can be matched to the practice. You'll get money. They want to get all the money out before the end of August. So another six weeks or so. And, you know, we've been trying to help our members and Ben will speak to this, I guess, in terms of where some of the hangups have been and, you know, what we've done internally within Adso's membership to minimize the pain for our members. The one thing that I will say on the front end is that hhs, in our discussions with them, were very, very clear that when you enter a tin or an ein on the application form, make sure that the name that is on the application for that entity matches what is on the W9. Because some of the early hiccups that they had, both matching Medicare practices as well as Medicaid and chip practices, not just within dental, but other providers as well, was that the tin ein did not match exactly the name submitted on the online application. So with that, Emmett, if you have any more questions for me.

Yeah, no, I just taking enough time. I really appreciate you explaining it because, you know, on the other side of this is all of us filling out applications, mad that our money's not coming fast enough or whatever it might be. You know, and the reality is there was a lot of hard work put in. As much as the media wants to say government decides to give money, you know, to dentists or whatever it might be, the reality is it took a lot of heavy lifting. So we appreciate that work and it gives us a little bit of empathy towards, you know, what the details are when we're trying to move the cogs of government here to help benefit this industry. So. And, you know, I want to remind people, and I think everyone knows, even though Adso was the one working on this, it doesn't just benefit DSO practice. This was for all dental practices, which I think really speaks to Adso's mission of moving this towards the future, you know. So, anyway, absolutely. Thanks, Chris. Well, okay, so other guests. And Chris, feel free to pipe in along the way because you've done a lot of work helping out the members. But we have several of the members here. We've got Ken Kaufman, who is CFO of National Dental Partners. And so, Ken, thank you. You've done several co host and hosting of DSO Secrets. And in fact, I shared with somebody the other day. They were asking me about ebitda and I said, ken's done a ton around EBITDA here in these podcasts, so thank you for being on.

Yeah, thanks for Having me, Emmett.

Yeah. And then Preston, who does revenue cycle management for Community Dental Partners and has done quite a few of these applications. So he's been in the trenches. So thanks for being on, Preston.

Thank you.

Yeah. And then Ben, and I'm going to let you. Ben's with HERO Dental. But Ben, I'm gonna let you start off and if you wanna give a little bit of your background and kind of talk about your experience in these applications.

Yeah. So thanks for having me on. I do. I work for HERO Practice Services. We support practices that focus on Medicaid, Pediatric dental across the country. And my back.

So you guys were some of the first. As soon as the Medicaid applications came out, you guys were assessing the risks around this, doing the applications, all of that stuff, correct?

Yeah, we were on the front lines of that and we kind of had an all night session with our Rev Cycle team, Compliance Legal, which you know, is a huge, huge team also at hero. And we all got together and just knocked through a couple applications first. So we had a good template to then fill out the rest of them. So our supported practices got in line pretty quick because we had the resources available to do so.

Yeah, that is a benefit for a dso. Right. As you're able to reach out to Compliance and Legal, have revenue cycle management, CFOs and others support you, what were some of the things that you noticed right off that maybe the team had concerns around that you kind of needed to assess? Do you remember?

I think the biggest concern is just the fear of, the fear of the unknown and fear of enforcement that the space, especially with Medicaid and now with everybody getting these funds, you're all kind of getting brought into the fun world that I deal with of government regulations, of the money that they give out. But making a mistake can have consequences. And I think that was everybody's first concern was if we mess up on this, what is the harm that's going to fall upon our supported practices? What's the harm that's going to fall upon us? So that was the first thing is going back to square one. You got to read. So we had to read the instructions and they weren't totally in legalese, they were okay to follow. And then it was just, we kind of, we had a screen share just like we're having right now. And everybody went through and in the sections that they had the expertise in, they looked at that and said, this is what this sentence means. Right. So this is what revenue means. And so speaking to Ken's point being a Lawyer and compliance. My concept of EBITDA is not as full as others, so I would have to defer, you know, on how do you classify that? But the big thing was just making sure everybody knew the right thing to do. And once we knew it, we did it.

Well, I appreciate Ben being an attorney, telling us that it wasn't in too much legalese for you, so that's good. I would defer and ask Preston. Preston, was it too much legalese or how did you feel about it?

Actually, it wasn't too bad because I've been going through some other legal documents recently that are a lot of legalese. This is not too bad. But I would say that if there are people out there that are wanting to apply, there's some pretty good instructions that are out on the web, and I would point them. You probably get about 95% of the information you need to apply by getting the instructions for the Medicaid provider distribution form. So it was really helpful. They want you to gather basically about 35 fields of information, and it just goes one by one for those fields and it defines what they want to see. And that was just a very helpful document. If people are out there looking to apply, track that now, we could probably post a link to it too, I guess, in DSO Secrets. So you could.

Yeah, let's do that. That would be excellent. Was there. Do you remember any of the 35 pieces that was more difficult to either understand or.

Yeah, yeah. I think it's important. There's a couple documents that you have to upload, and so I think it's important that people start tracking those down. Tax returns. Is one of them your most recent tax return for the entity. And then there's some payroll reports for Q1, 2020. It's the form 941. And then there's some. If you're applying for the Medicaid distribution, there's some NPIs and things like that you have to collect. If you're going for the general dental distribution, you obviously don't need the Medicaid, the NPIs, and things like that. But yeah, those types of things. I would start reaching out to your different departments to have that information so you can start gathering it, especially since the deadlines are coming up pretty quick.

Ken, what were your thoughts as you looked over it and what were some concerns you had as you thought about the support practices that you're supporting?

I had a few. I do want to clarify one thing, and maybe Chris will know the answer on this one, but the Medicaid providers The deadline is set as July 20th. And then when they expanded it, the deadline was expanded July 24th.

Yes, that's correct.

And to be clear, so is the Medicaid provider, is it still July 20th or is it now any provider can stretch to July 24th.

My understanding is if you have a Medicare provider in mpi, as Preston said, that you should get your application in before July 20th.

Okay, great. That's helpful. I know I've heard some questions on that and hadn't heard clarity, so thank you. Another thing that came up, Emmett, as I read through all the documents, was they made clear that we were going to need to provide quarterly reporting. The nature of that reporting is not clear, nor is the termination of this quarterly ongoing process. And so those were two things. Back to Ben's comment about everybody's afraid of messing it up. Besides that, I was afraid of, okay, how long are they going to be wanting us to provide? Because it takes a lot of work to prepare reporting, send it out. And that could put a big burden administratively on an organization, besides the fact we all like to keep our financial information pretty close to the chest. And so, you know, sharing it broadly, knowing that our names are names of practices are going to be put out there as to who's receiving funds. So those were some things. And if, you know, Ben or Chris, if either of you have any guidance or thoughts on that, I'd love to hear it. And I'm sure our listeners would, too.

Yeah, Ken, that's a great question. Sorry I didn't answer that or address that in my comments. We're still trying to get an answer from HRS and HHS on how long a reporting period is. Is it a date certain end? Is it a ad infinitum, which we're certainly would push against and are pushing against, or is it because you need to account for how the funds are spent to make sure they're not spent in areas that are not allowed? So is it just an accounting through the time when you account for all the funds, which would certainly be what we've advocated for, but we haven't gotten a direct answer yet. But that's where that's at. And as soon as we get any further information on that or clarity, we'll be sure to push it out to our members.

Yeah, that's great.

Yeah. I think it's in fairness we should say Adso hasn't stopped working on this along with PPP or any of these other components. There's still active individuals at the federal level that are helping to continue to clarify things and provide that information to its.

Yeah. And let me just interject on here, because initially we believe that again, it's a grant, and we believe that the grant was going to be tax exempt. The IRS just recently issued a guidance saying that HHS provider relief funds are taxable as income. But there's a huge coalition here in D.C. that's pushing against that. And we're more than likely to see yet another stimulus package in the fall. Stimulus four, the CARES act was stimulus three and stimulus 3.5. But there's a large coalition of which ADA, excuse me, ADSO and ADA are a part of that, is pushing back against the tax implications because the IRS is saying that the tax will be approximately 21%. So they're given 100%, but they're clawing back 21%. We're saying, look at our members and their supported practices were disadvantaged 100% and are only getting 2% of the gross annual revenue. If you want to gross it up a little more to claw back to 21%, we'll be willing to entertain that. But, you know, let's talk.

Yeah.

Excellent. So thank you again. I don't think people realize that that doesn't just naturally happen. Right. You have to have a team that you're financing to help create those solutions. So, Ben. Yeah, go ahead.

Yeah. I want to go back to the reporting and record keeping and disclosures of the funds received. That is one of the things that as a company, we're advising our supportive practices to treat this the same as medical records, so to speak, regardless of if you have to report it or not, retain those records, you know, like for, you know, I see Ken nodding his head like, like a CPA would tell you to do, retain the records and make sure you have really good documentation of where that money went to. Everybody that I've spoken with wants to do this the right way. They're just not totally sure how to do it. And as we've all said on the, on this meeting, there's no guidance, you know, there's no firm guidance as to what you need to do. So my advice is always, as a Southern expression, is belt and suspenders. You know, make sure you document it. Make sure you read all of the areas where you can spend the money and all the areas where you cannot spend the money. And it's very important.

What are some of those that come to mind for all of you? And Ben, I'll start with you areas you can and can't.

I mean, first one, as you know, a lot of us are sitting here. Executive salaries, you know, executive salaries cannot be paid for with this grant.

There is something need to kind of worry about then increasing their pay as a practice owner. Could that get interpreted as an executive salary?

I don't believe so. But I would say I'm not giving you legal. Here's my legal advice. I'm not giving you legal advice. Please contact your own internal or external attorney to let you know from the doctor's perspective, I would say no, it's not executive, but, you know, it's every person, every entity structure is different. And so it would be very fact specific.

Maybe if you have three locations or two locations now, they interpret you as executive.

Right, right, exactly. So I would say please contact both your lawyer and your CPA and make sure that that's correct for your specific organization, for your specific practice. You know, one of the other confusing things on it is that it talked about treating COVID positive patients as one of the requirements. And I guess that's not. I might be switching. Switching gears.

Yeah, Just another piece that was confusing.

Yeah, it's just another confusion piece is

that

they assume everybody's COVID positive. So don't worry about that. Requirement for getting the funds is that you don't have to prove that one of your patients you saw subsequently got a positive COVID test. Just like we advise all of our supported practices, treat every patient that comes in as if they're COVID positive. That's what the CDC is telling us. That's what the departments of health are telling us. And that's what we've been told HHS was looking for, is did you see any patients? So that was confusing for a moment for my team until we looked at all the other guidance for that. But yeah, just.

That's really helpful. Chris, did you want to add anything to that? You guys did some work.

Yeah. For those of you that might have participated, there have been a couple webcasts that HRSA and United Healthcare Group have had, and that was one of the questions that came up. I think the. And again, Ben, you're the attorney. I'm not, but I think the language is known or suspected. COVID 19 patient. And HRSA said for the purposes of eligibility and application, any patient you see is either known or suspected.

Right.

That's helpful.

And you know, in talking about the other things for funds, it's sort of confusing. You know, spend it on stuff that is Covid related. Right. What are we doing right now?

PPE use.

I know a lot of our supportive practices, their PPE costs have increased tremendously, a lot more than many insurance payers want to recognize. And definitely the states are not recognizing the increased costs. So it's a very easy. That's a very easy avenue for the funds to go to is the increased PPE costs that all dental practices across the country, if not world, are facing.

Now I could add a little bit to that too. They also mentioned lost revenues due to COVID 19 and any expenses that were not covered by your lost revenue. So you still had some expenses in April and May that were going through your dental practices and you lost whatever you lost during those months. Those expenses that were not covered during that period by the revenues that would have been there could be used as well. And they actually they have a frequently.

Would that be specific with rent?

Yeah, I'll give you. They have a frequently Asked Questions section on the HHS website and it's really great. I recommend people go look through it. But these are some specific things that they list on there. They say employer or contractor payroll, employee health insurance, rent or mortgage payments, equipment lease payments, electronic health record, licensing fees. And they're still trying to work out more of this, but I think they're trying to give us a sense of what we can be looking at.

Yeah, that's helpful. Ken, how are you thinking about organizing this? Because there's the reality of what it can be spent on. So I could look at my April and my May and I can say, oh, here's $10 for this and $20 for that and so forth. But then there's the efficiency of maybe allocating it towards something that's easier to keep the reporting on. Right. So what's different ways that, you know, Ben, Ken and Preston that you've thought of as far as creating maybe some simplicity. If someone says I want to see where you spent this on and you say here's the report.

So Emmett, I'll chime in here first. The first thing, and I've been a little bit vocal on this for, you know, all of the supported practices, especially when there's multiple practices that are together or being supported by a similar organization. The challenge or the challenge with some of the advice that came out back at the PPP time was get a separate bank account, put your PPP funds in it, then spend directly out of that account. But what happened is if there were, let's say 10 supported practices, all of a sudden there were 10 brand new accounts. They had to go and redirect all their payroll, all their AP that's automated and bank drafts and wires, and it completely messed things up internally. And so I've been asked already several times on this one, hey, should I get a separate bank account for these funds? My answer is no. And it's the same answer that I gave those when I that said don't get the extra bank accounts for ppp. It's just keep track of how the money is being spent out of the account. And then to the degree that you can create a really nice clean bucket of, I took all the money and I spent it all on this. For example, if you were to dedicate, if, let's say you used up your PPP funds on payroll and now you've got rent that you didn't end up having forgiven through that, say, here's the six months of rent that I was able to use these funds, or it would probably be less based on the, you know, 2% and how that works. But, you know, here's three months of rent. These are the bills. This shows the money going out. Here it is. And here's my nice, clean file, documented. It has nothing to do with what bank account it went into or came out of. It just has to do with, I received, say, $50,000. And here's how I spent the $50,000 with documentation.

Well, and you bring up a good point, Ken, is there's been the PPP stimulus, There's been the Eidl loans that have been there forever but got activated. And then now you've got this HHS funds. And there's many practices that qualify for each of these. Some of them are pretty deliberate in saying, I know with Eidl and ppp, that they shouldn't be used for the same thing. I would assume hhs, you would want to abide by those same, that same principle. And so there's. It's, I think, very important for us to be thinking about. And Ben, I'd love your opinion on this as making sure that if you've got PPP funds, EIDL funds and HHS funds, that if you're using them all for payroll, that you're very clear on, this was for this time period. This was for this time period. And this was this time period. Really tie those out. Or as Ken said, this I used for payroll and this one I used for covering leases or rents. How has HERO kind of addressed that, if you don't mind sharing?

Yeah, we, we're doing it like the, like what Ken said with rent. You know, some PPE costs as well, but mostly we felt the safest way to do it. And the easiest way to, for an audit or for a report to show the, the appropriate use of the funds was to put it towards rent. It's a pretty easy thing to track, relatively speaking. It's not commingled with other funds. What we, we were looking into the setting up a separate bank account for each supported practice and like Ken said, it's just, it's not realistic to do that amount of legwork when you could just track the funds. So my, my advice would be like what Ken said is, you know, use it. Make sure you specify what, what bucket it's going into and make sure that bucket goes to a specific expense and document that. And then once you're done documenting it, you know, make three or four copies and put it in different people's file cabinets and go on your way. But you know, it's one of the things, you don't have to get creative with this. There's so many expenses.

Ben, would you argue the opposite of don't get creative with this?

No, I know, that's what I, I'm sorry, I meant to say that don't get creative with this. You don't need to be creative on how to put this into this bucket and this into that. And you know, are we going to pay for these people salaries from this thing and that thing? No, if you can get, if you can get it all in rent, do it all in rent. If you could do it all for PPE costs, do it all in PPE costs depending on your Medicaid or I guess now it's going to be the full scope of it. But make it easy, make it easy

for yourself and Ben, by simplifying it. I'll just, I want to give the listeners just one step deeper into how to do that. Just have an Excel spreadsheet and mark down each of the things you're spending the money on. And then make sure that you've got one piece of documentation to validate that that's a real, you know, valid expense. And if you can even show it leaving the bank account, that's even better. And you're literally done. And then make sure whatever is documented on that for hhs, you're not double dipping and counting that same time period of those expenses or those exact same expenses on how you're utilizing the PPP funds or the EIDL funds. So just very, very simplistic it can be. Such a basic spreadsheet is like three columns of name of vendor, dollar amount, date spent, and then have your backup Documentation, and I think you're solid.

That's really helpful. One of the couple other things that I got questions on is it looks like the quarterly reporting is also required on the PPP and Eidl, if you got those. But we don't have total clarity on what we're supposed to report yet. Is that accurate? That was a question that came through.

I think Chris might be the closest one to maybe knowing that answer.

I don't know quite honestly. Once we solve some of the PPP issues, it was like, onto the provider relief fund. I haven't rewound to that well.

No, no, no.

What I mean is in the HHS fund, I think in that quarterly reporting requirement, if you've taken any EIDL or ppp. So this would be something worth looking at. I think in your quarterly reporting, you have to address what you've done with the PPP funds as well, and any Eidl funds you've received.

That might be. Ben, do you know the answer to that?

No, we didn't qualify for those, so we didn't get into it. And. But again, just the standard, you know, ask your lawyer and cpa, but make it just.

It's.

It's the simple rule of dentistry or any health care in general, is just document, right? Just document, document and document a little more and you'll be fine. That's really about it. Nobody wants to do the wrong thing that I've spoken with in my 12 years of doing this and just document it. Reach out to experts, either some of the folks on this webinar or your council. Reach out to them. And the other thing I would plug in or I would make a plug for is the helpline on this provider relief portal. They actually answer the phone and they will actually talk to you and give you answers. I mean, it is the craziest thing in the world. At one point, one person on my team said, well, why don't we just call the phone number? And I was like, well, yeah, good luck with that. I'll hold my breath until you get an answer. And lo and behold, they picked up the phone. So reach out.

And they're actually starting to get more and more accurate. I know that early on they picked up the phone, they said, we haven't heard about that. You know, I was like, okay, well, we're a little bit ahead of you. It's a benefit of having access to someone like Chris. So it hadn't made it down to the front desk call center yet, but now I've heard good responses as well, as far as. And it's good the government has lowered our expectations so much that we're happy to just get a response. Another one you all might not be up to date on is I saw it on one of the social media posts. There's some concerns in one of the documents. It says that you need to something around accept all insurances as in network fees even if you're out of network or something to that nature. Did you see, did anyone else see that or can speak to that? Preston, you're nodding your head yes in

the frequently asked questions. There's a few questions around that and they are asking people to, to basically charging network fees even if the patients are out of network. I can't remember all the details around it, but if you go to the frequently asked questions on the HHS website, you'll be able to read into that a little bit more.

So I look for things like that. Cause I think as all of us are trying to do the right thing, as Ben mentioned, it's so easy for a provider to mess that one up, right? It's just, hey, I accept these insurance, not these insurance some frontline person just trying to do their best to make sure billings are correct, et cetera. And for some period of time we need to kind of think about that differently and make sure everyone on the team understands that. In fact what was on the social media post is so if a Medicaid patient comes in, even if I don't accept Medicaid, you know, do I need to then accept Medicaid fees, etc. So there's things that you know, I won't answer, ask you all to answer that, but those are things to start navigating and if you're out of network with some insurances, maybe looking and auditing any kind of out of network activity for a period of time while you have these funds. And we'll put pressure on Chris to continue to work to say hey, once we've spent the funds we can go back to normal again. But until that quarterly reporting, until that finite date is really clear, it's in the government's purview to be able to say if you accepted these funds, you have to do this for the next two years or whatnot. So we definitely would like it to be during the time frame that we had the funds until we've spent them. So these are all things that yet to be seen, like the PPP rolled out. Hey guys, apply hurry up. Well, how does it work? We'll tell you later, you know, so we'll just continue to try to do our best. Any kind of closing thoughts? I really appreciate you all being on. I think this will be very helpful to have kind of that comprehensive view. Anything we didn't touch on, people can make posts, ask questions around it. I can bring those back to you all and post them there at DSO Secrets on the Facebook page. Or we can continue to try to chase those down with the government.

I've got some thoughts, Emmett. For anybody that's thinking of applying, they need to act pretty quick. And there's one thing that I got caught up on when I was applying at first. It's kind of a three step process to apply and that first step is to do the tin verification. And once you apply for that, it takes about a day or two for that to go through before you can move to the next step. And with it being July 16th and the deadline is the 20th, they're going to want to apply for that 10.

Like now it's the 20th for those who are accepting Medicaid.

That's for Medicaid. Yes, that's for Medicaid.

But if you're not accepting Medicaid, you got a little bit longer.

Yeah, you do have longer. But still, even if. Yeah. So though, everybody, if you're planning on applying for this, you should start that tin verification process right now. There's about 12 items of information you need to gather to do that piece. So it's not too bad. But then that allows you to do the rest of the application two days later once it gets verified.

So yeah, there is, as Chris said, the last thing the government wants is some headline of funding some cartel or anything like that with HHS funds. So they're doing their best to kind of verify things along the way. So this team 10 is kind of the big one that we're not used to in most credentialing or other funding processes. So that has to be completed. What's step two? Once that's verified, do you get an email by the way?

Yeah, you get an email or you can go and check the website and there's basically these three little sections and it'll tell you once the status moves on to the second part of the application and it'll allow you to click into the second part of the application. So if they submit for the TIN today, then maybe, maybe tomorrow or maybe Monday, that second part will open up and then they can click into it and provide the rest of the information. So yeah, I mean they probably got to act pretty quick for the Medicaid side and on the general side probably

too, you've been supporting Preston quite a few practices. In fact, I know that there are some other groups out there that have your phone number. We won't give out your phone number on this podcast, but I was talking to some dentists and I said, hey, how are you doing on that? And they said, oh, fine. I called Preston, he's helping us solve it. So anyway, thanks for supporting that. I've also heard just kind of in closing and Ben, you were kind of ahead on a lot of this application that funds are starting to come in. Those who did it 10 to 14 days ago are starting to see some funds. So I don't know, Ben, if you have already yet or not.

Yeah, we're starting to see some come in. And you know, to Preston's point, some of our applications for the tin verification, we got confirmation within two hours and some it took a week. So, you know, please, everybody that's, that's listening, go fill it out today. You know, hang up and start filling them out because it might take a while. But yes, we are starting our supported practices are starting to receive the funds. It's a pretty easy, you know, you wake up and it's in your, your bank account and then it's up to you to make sure you do the right thing with it. And so that's my, my parting words is, well, two things. One, make sure you fill out the form correctly the first time. Right now the deadline is fastly approaching. Make sure you're on the IRS website and see how they have your name. Or look, look at some of the forms from the irs. Make sure your name is spelled correctly when you put it on your form. We had one supported practice that I've spoken to that didn't. They had a letter different in one of the names and what they've always put on their, you know, letterhead and hey, just make sure the data matches. Make sure your NPI data, you can go to the next lookup for NPI lookup, make sure that NPI data matches the IRS data. And because otherwise you're going to have problems. I mean, it's their computer algorithms looking at this. It's not an individual. So, but then my parting word is don't get creative. This is not something, this is not an area to be creative. This is an area to be very, very dull and plain. Spend it on rent, spend it on PPE supplies. I mean, don't try to figure out, well, can I pay this employee this amount? Because if it's with PPE or if it's with the PPP versus this fund and are they an executive or if they're a doctor and they own the don't. There's no reason to make it more complicated than it is. We live in a complicated world. And I guess that's not great legal advice if you want to bill by the 10th of the hour, but it's great legal advice if you want everybody to be good. So don't make it complicated. Don't make it creative. Just, just do it.

And thank you, Ken.

Yeah, I like Ben's. I like his tone there. All of us are just concerned about what we might not know or what might come up at some point down the road. Keeping it as simple as possible is the name of the game here in how you report, how you document and to the degree you think maybe I need to document with this and this and this too. No, just go with a simple basic process. Give the basic information. Don't try to over educate or you know, give too much information, one through the application process and then two through the through the quarterly reporting and updates. I like that, that message.

Great. Thank you Ken and Chris, thanks for letting us stand on your shoulders and your in your hard work. Any parting words?

Yeah, just real quick. As everybody said, there's like for the Medicaid chip providers, there's only four days left to apply for the general dental distribution. They compress the timeframe. We originally were told that it was gonna be the end of July, but they pushed it up for whatever reason to the 24th of July. So if you're cash, either insurance or cash pay or a mix of both, make sure that you get your application in as quickly as possible. HHS has said that they will be processed, the applications will be processed on a first in first out basis. So as Ben said, some of the supported practices are already receiving the benefit. But the longer you wait, the longer you're going to wait for the money and if you need it, and I'm sure you do, get on there today. Like Ben said, after this webcast, hang up and go directly to the application site. Get your application.

Well, thank you gentlemen. I really appreciate your help and getting this information out there. And as I said before, if anyone has any further questions, come over to our Facebook page on DSO Secrets. And until next time, keep smiling.

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