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COVID-related Cash Flow Modeling Template

  • 1.  COVID-related Cash Flow Modeling Template

    Posted 03-23-2020 14:07
      |   view attached
    I created a Cash Reserves Modeling template and attached it to this message.  I also uploaded it to the Library.  The template allows users to estimate the impact of anticipated revenue losses may have on group practices' and imaging centers' cash reserves.  Instructions are included.  Users need to have historical revenues for both screening services and non-screening and historical expenses, and their current cash balance.  The model allows users to enter different initial loss percentages for Screening (often 100% for now) and non-screening imaging (some are reporting 30% to 40% drop).  The model allows users to create 5 different recovery Scenarios by entering the the "Recovery Rates" per month for the different scenarios.  Default recovery rates are provided.  This allows one to show the impact from an best case through worst case scenario.  Have fun and good luck!  MB

    ------------------------------
    Michael Bohl FRBMA
    Strategic Advisor
    Radiology Group, PC, SC
    Bettendorf IA
    (563) 484-0488
    ------------------------------

    Attachment(s)



  • 2.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-23-2020 15:11
      |   view attached
    Thanks.  This is a good exercise, and everyone should undertake some form of projection.  Pay attention to special circumstances in your analysis.  I've never met a radiology group yet that didn't have them!  We have looked at:

    1. Fixed costs - approached our landlord and other vendors regarding relief
    2. Variable costs - cutting where we can
    3. Available resources - SBA, line of credit, state relief for our staff who are impacted (California has new policy for staff whose hours are cut, though not terminated or furloughed)
    4. Schedule changes due to decreased volume
    5. Desire to provide assistance to staff who are impacted
    6. Whether you must comply with the Families First Coronavirus Response Act just signed into law.  Certain healthcare providers will be exempt (regulations yet to be published will define this), but if not, you must provide 80 additional hours of sick time to staff whose children's schools are closed due to the Coronavirus.  Similarly you must provide up to 12 weeks of FMLA leave for the same reason (schools closed), 10 of which you must pay 2/3 wages.  So combined, if you are subject to the law, you potentially have an additional 12 weeks of pay for workers who aren't there.

    We have other considerations unique to our group, both good and bad, that have to be mixed in.  Lots of fun.  Good luck.  

    As an aside, let's hope someone can convince CMS and the politicians that it would be an excellent idea to include emergency relief to physicians in the form of increased Medicare reimbursement in all the aid packages being discussed and debated.  They need doctors now more than ever, and seeing them shutter their doors is the last thing we need.  We sometimes seem to forget that Coronavirus isn't the only sickness out there.  There are lots of other patients suffering with lots of other conditions.  They need care too.

    Trusted to provide 
    expert and caring radiology services for over 60 years

    Wayne Baldwin
    CEO
    (805) 879-7577

    CONFIDENTIALITY NOTICE: This electronic mail  may contain information that is confidential, privileged, proprietary, or otherwise legally exempt from disclosure. If you are not the intended recipient, you are hereby notified that you are not authorized to read, print, retain, copy or disseminate this message, any part of it, or any attachments. If you have received this message in error, please delete this message and any attachments from your system without reading the content and notify the sender immediately of the inadvertent transmission. There is no intent on the part of the sender to waive any privilege that may attach to this communication. Thank you for your cooperation.




    Attachment(s)

    tiff
    PastedGraphic-7.tiff   30 KB 1 version


  • 3.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-24-2020 11:04
    This is much appreciated Michael.

    ------------------------------
    Lee Johnson
    Adirondack Radiology Associates, PC
    Glens Falls NY
    (518) 793-1000
    ------------------------------



  • 4.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-24-2020 11:30

    Yes, Michael excellent work and I really appreciate you sharing this.  It's going to be very enlightening for our Finance Committee.  Some tough decisions ahead.


    Matt DesRosiers

    Winchester Radiologists, P.C.

    Winchester, VA

    540-431-3525

     






  • 5.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-24-2020 11:32

    Michael, I too, really appreciate you sharing your work.

     

    Phyllis Fulk

    Administrator,

    Imaging For Women

    630 NW Englewood Road

    Kansas City, MO  64118

    Phone: 816-453-2700

    Fax:  816-453-9943

    Direct Line:  816-268-3309

    image001.png@01D18F32.7E281D70

     

    CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information.  Any unauthorized review, use, disclosure or distribution is prohibited.  If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

     






  • 6.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-24-2020 11:48
    All,
    Here is a link to version 2 of the spreadsheet.

    This version eliminates a formatting issue some may experience in the chart by freezing the Y-axis values.  I manually placed the heavy horizontal red line across the $0 line so you had a clear indication of when your values went negative.  In the original version if the Y-axis values could change depending upon the dollar values in your practice.  If that happened, the $0 line could float up or down, but the manually placed red line would not.  In this version I froze the Y-axis values so the $0 horizontal line won't move.    
    The other solution would be for users to Unprotect the worksheet and manually move (or remove) the horizontal red line themselves. 

    If you have any questions feel free to email me at mbohl@doseregistry.com.  


    ------------------------------
    Michael Bohl FRBMA
    Strategic Advisor
    Radiology Group, PC, SC
    Bettendorf IA
    (563) 484-0488
    ------------------------------



  • 7.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-25-2020 11:00
    Mike,

    Excellent work. Thank you for sharing.

    ------------------------------
    David Haid
    CEO
    Cheyenne Radiology & MRI
    Cheyenne WY
    (307) 634-7711
    ------------------------------



  • 8.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-25-2020 11:21
    The link in my previous post is broken due to a version change.  Here is a link to the web page with the link embedded in the article.  These were minor, formatting-related updates:  The most recent eliminates the chart formatting issue described above as well as adds color coding to the results matrix below the chart.

    ------------------------------
    Michael Bohl FRBMA
    Strategic Advisor
    Radiology Group, PC, SC
    Bettendorf IA
    (563) 484-0488
    ------------------------------



  • 9.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-25-2020 11:14
    Hi Michael,  I unable to get the link to work for me to the "version2 of the spread sheet,

    Can you please sent to me at DRusso@specialtyimaging.org

    thank you





    ------------------------------
    Donna Russo CPC
    RCM/Account Manager
    Danbury Radiologic Associates
    Danbury CT
    (203) 361-4909
    ------------------------------



  • 10.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-25-2020 11:23
      |   view attached

    Donna,

    I just updated my post to include the link to the most recent version.  I attached it to this email for you.

    MB

     




    Attachment(s)



  • 11.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-25-2020 11:32

    Thank you Michael!

     

    Donna Russo, CPC

    Revenue Cycle Manager

    CT Women's Imaging

    Danbury Radiological Associates

    Specialty Imaging Associates

    Mandell and Blau

    Direct Phone 203-361-4909

    Direct Fax 1-203-841-1327

    OfficeFax   203-748-0833

     






  • 12.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-25-2020 13:08

    All,

    A couple of people have emailed asking if I provide consulting services to help them analyze their practice's exposure.  I am certainly willing to help in any way I am able.  Click here to send me an email if you would like to discuss how I can help.

    MB

     

     






  • 13.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-25-2020 13:40
    Hello
    Also wanted to mention that those of you who outsource your revenue cycle services should be leaning on your vendors as well. They are managing your revenue stream and should be providing detailed projections.

    ------------------------------
    Rebecca Farrington
    Chief Revenue Officer
    Healthcare Administrative Partners
    Media PA
    (610) 892-8889
    rfarrington@hapusa.com
    ------------------------------



  • 14.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-25-2020 15:21

    Rebecca, how is your firm coping with claims processing and the need to have people stay at home during the public health emergency?

     

    John

     

    ---

    John E. Pugh

    Pugh Healthcare Business Advisors

    P: 609-644-4479 F:609-503-2476

     

     






  • 15.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-26-2020 11:02
    Hi John,
    Thanks for the question. We have been lucky in that we utilize a variety of employment set ups for our operations team. Because of how competitive the job market has been, we have already had a partial work from home model for the majority of our employees. When this crisis hit we had the right set up for our team members to transition to full work from home. Those critical in-office tasks are being completed by a rotating skeleton crew. The interesting twist regarding this whole issue is the partnerships with off-shore Indian based companies. Every revenue cycle provider has these partnerships. What varies is the dependency on these partnerships. Unfortunately, India is being impacted with the Covid-19 crisis. The difference is they are not typically set up with work from home flexibility so this transition has been and will continue to be challenging for those companies. Revenue cycle companies who were relying on those off-shore partnerships to help offset any on-shore employee health issues  will now have to find other options quickly. They can't simply redirect an increased volume as easily as anticipated. The reduction in using off-shore partnerships (which will now need to be managed on-shore) will also have a revenue impact on you revenue cycle company. So, as you can see...the impact of all of this is far reaching.
    Stay safe!
    Rebecca

    ------------------------------
    Rebecca Farrington
    Chief Revenue Officer
    Healthcare Administrative Partners
    Media PA
    (610) 892-8889
    rfarrington@hapusa.com
    ------------------------------



  • 16.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-26-2020 11:42
    Hi Rebecca,

    I must disagree with you that every revenue cycle company outsources to India.  While a very high percentage of companies do, there are a few of us that do not outsource to India or any other overseas company.  Our company has easily transitioned our work force to work remotely since they work in our US based offices, along with our staff that already worked remotely.  Our biggest challenge is dealing with the reduction in services provided by our radiologist groups. 

    I've been involved in a several calls with the HBMA where a very high percentage of the companies outsource to India and the Philippines and are struggling with how they can maintain their services.  I was told that Indian staff live out away from the cities, use public transportation to get to work, and typically stay in hostels during the week.  With a complete lock down they don't even have transportation to get to work if they could work.  And, they aren't set up to work remotely. 

    We will all get through this and learn many lessons.

    Stay safe everyone.

    Cindy Pittmon


    ------------------------------
    Cindy Pittmon RCC, CHBME, FRBMA
    Founder, President, CEO
    Acclaim Radiology Management
    Longview TX
    (903) 663-4800
    ------------------------------



  • 17.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-26-2020 11:57
    Hi Cindy,
    Stay Well and take care! Looks like we all have our unique challenges regardless of our set ups. Hopefully this will pass soon and in the interim we can do everything we can to support our clients and amazing groups like the RBMA. 

    Rebecca

    ------------------------------
    Rebecca Farrington
    Chief Revenue Officer
    Healthcare Administrative Partners
    Media PA
    (610) 892-8889
    rfarrington@hapusa.com
    ------------------------------



  • 18.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-26-2020 12:19

    Rebecca

     

    Not all RCM companies outsource to India. Other than coping with the decreased volumes, my billing company has easily transformed to working from home without missing a beat.

     

    Paul Coogan

    President

    Avoca, LLC

    502 753-4922

    pcoogan@avoca-med.com

     

     






  • 19.  RE: COVID-related Cash Flow Modeling Template

    Posted 03-26-2020 12:34
    Thanks for your perspective stay healthy!

    ------------------------------
    Rebecca Farrington
    Chief Revenue Officer
    Healthcare Administrative Partners
    Media PA
    (610) 892-8889
    rfarrington@hapusa.com
    ------------------------------