different world, clinically and financially," says Keith Gruebele,
president of BHG Patient Lending. "Facilities will have to do their
part to provide patients with creative ways to get their surgeries
done in ways that will fit into their new budgets."
When creative financing options for patients are found, it's impor-
tant to collect every penny of copays and deductibles, because they're
the quickest and likely urgently needed payments your facility will
receive. Mr. Gruebele estimates that reimbursements from insurance
companies overtaxed from COVID-19 claims will take two to three
times longer to arrive than before. The key to remaining fiscally sound
in the short-term is to have at least three months, and preferably six,
of operating expenses in a rainy-day fund. Mr. Gruebele estimates that
most ASCs have less than one month in their reserves. Unless your
physician-owners are willing to dip into their own pockets to create
the reserve fund, you should be working to secure long-term financing
now.
"The truth is that the halt in income has been catastrophic for some
centers," says Mr. Gruebele. "My fear is that facilities will get their
Paycheck Protection Program Loan and some advances from the
Centers for Medicare & Medicaid Services (CMS) and be on a stimu-
lus high that makes them think they're in a better financial strait than
they really are. That money will be spent very quickly."
Mr. Gruebele says restart costs could be almost as high as a facility's
startup costs: Devices needs to be recertified; new meds have to
replace expired ones; emergency and backup gear must be tested; and
additional PPE must be purchased.
"The industry needs to awaken to the reality that the post-COVID-
19 world will not be solely felt in the clinical setting," says Mr.
Gruebele. "It will be felt primarily in the revenue cycle, in your abili-
ty to bill and collect from patients, and in how you can manage your
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