Resources to Help You
Use the resources below to help your business, improve remote care delivery, code for COVID-19 and access Kareo support.
Navigate the COVID-19 Crisis
Government Stimulus Package Approved
With President Trump signing the $2 trillion Coronavirus Aid, Relief and Economic Security (CARES) Act into law on March 27, 2020, it will provide much-needed financial help to independent medical practices. According to the American Medical Association (AMA), 54% of all physicians work in independent practices and many are struggling to keep their doors open and staff employed as a result of the coronavirus pandemic.
The current struggles of independent medical practices are often due to the canceling of non-COVID-19-related doctor appointments on top of other challenges they face in “normal” times such as various reimbursement cuts, EHR implementation costs, regulatory obligations and more.
At Kareo, we are concerned about the success of all independent medical practices. To help you better understand the CARES Act, we have listed the most recent details that can benefit your practice in this midst of the coronavirus crisis.CARES Act Offers Relief, Support for US Healthcare Sector During COVID-19 Response
View the Chamber of Commerce Small Business Guide and Checklist
$117 billion allocated for hospitals and health systems
This funding is to replenish supply shortages, give more access to telehealth services, and pay for diagnostic testing and drug creation for treating coronavirus. Eligible providers are defined as public entities, Medicare- or Medicaid-enrolled suppliers and providers, and other for-profit and non-profit entities as specified by the Health and Human Services (HHS) Secretary.CARES Act Offers Relief, Support for US Healthcare Sector During COVID-19 Response
View the Chamber of Commerce Small Business Guide and Checklist
Small businesses loans available
The CARES Act expands eligibility for loans under Section 7(a) of the Small Business Act and authorizes the SBA to make $349 billion in Section 7(a) loans during the period between February 15, 2020 through June 30, 2020. The loans will be guaranteed by the government and will be eligible for forgiveness for amounts spent on payroll costs, utilities, rent and mortgage interest during the 8-week period after the loan origination date, with such forgiveness amount reduced proportionately by any reduction in employee headcount or certain reductions in salary or wages.
Any business that has 500 or fewer employees or that otherwise meets the size standards established by the SBA for the relevant industry and businesses with an NAICS classification that begins with 72 (Accommodation and Food Services) with more than one physical location and which employ no more than 500 employees per physical location. Borrowers must make a good faith certification: (1) that the uncertainty of current economic conditions makes necessary the loan request to support the ongoing operations of the eligible recipient, (2) to acknowledge that funds will be used to retain workers and maintain payroll or make mortgage payments, lease payments, and utility payments, and (3) that the recipient has not received, and does not have another application pending, for loans under Section 7(a) for the same purpose.
Maximum Loan Amount
The lesser of $10,000,000 or 2.5 times the average total monthly payments for “covered payroll costs” incurred during the 1-year period preceding the date of the loan. “Covered payroll costs” include salary, wages, cash tips, payments for vacation, parent, family, medical or sick leave, allowance for dismissal or separation, payments for group health care benefits, payments of retirement benefits, payments of state or local taxes on employee compensation, and payments of any compensation to or income of a sole proprietor or independent contractor that is wages, compensation or similar payments up to an annual rate of $100,000 (as prorated for a covered period).
Exclusions (from including in payroll costs) is an individual employee in excess of an annual salary of $100,0000 (as prorated for the covered period), taxes under chapters 21, 22 or 24 of the Internal Revenue Code, compensation to employees whose principal place of residence is outside the U.S., qualified sick leave or family leave wages for which a credit is allowed under Section 7001 of the Families First Coronavirus Response Act.
Maturity and interest rate
Maximum maturity of 10 years from the date of the loan and a maximum interest rate of 4%. Allowable Uses In addition to the generally allowable uses of Section 7(a) loans, the borrower may use proceeds from the loans for payroll costs; costs related to the continuation of group health care benefits during periods of paid sick, medical or family leave, and insurance premiums; employee salaries, commissions or similar compensation; mortgage interest payments; rent; and utilities; or interest on any other debt obligations incurred before February 25, 2020.
No Collateral Requirements or Personal Guarantees
Borrowers will not be required to post collateral or have personal guarantees under the loans (as they would under typical Section 7(a) loans). The loans are unsecured. Fee waiver Fees normally charged by the SBA for Section 7(a) loans would be waived. The lending institution extending the loan may charge the Borrower a TBD origination fee. Deferral All payments of principal and interest under the loans would be deferred for a period between six months and one year.
Borrowers will be eligible for forgiveness of the loans in the amount equal to the sum of payroll costs, mortgage interest payments, rent and utilities incurred during the 8-week period following the origination of the loan. However, the amount of forgiveness will be reduced (i) proportionately by any reduction in employee headcount in the covered period with respect to either (1) the period between February 15, 2019 and June 30, 2019, or (2) the period between January 1, 2020 and February 29, 2020 (or other period for seasonal businesses), (ii) by the amount of reduction in salary or wages beyond 25% of any employee (measured based on the most recent full quarter before the covered period) who did not receive, during any 2019 pay period, wages or salary at an annualized rate of pay of more than $100,000.
Exemption in Loan Forgiveness
There is one exemption that will contribute to a reduction in loan forgiveness - if employees who were terminated or had pay reductions from February 15, 2020 through 30 days after the enactment of the CARES Act (signed on March 27) are rehired or given wages or salary increases by June 30, 2020. The SBA is required to issue guidance and regulations implementing these loan forgiveness provisions no later than 30 days after the enactment of the CARES Act (other rules implementing the SBA provisions are to be adopted within 15 days after implementation). Borrowers would not recognize any income for federal tax purposes on the portion of the loans that are forgiven.
Qualified Lenders and Application Process
The loans will be available from existing SBA-certified lenders (e.g., JP Morgan and Wells Fargo), and others that may be added. Our advisors noted there is discussion around whether existing SBICs may be approved to make these loans (TBD for now). For the application process, the SBA has a “beta” platform where businesses could apply directly which the SBA is hoping will go live next week. Alternatively, borrowers can apply to traditional 7(a) banks and other institutions that are authorized by SBA. We (Golub) are in dialogue with JP Morgan and Wells Fargo to better define what information will be required and will follow up upon receiving more clarity to help expedite processing.
The stimulus bill would give businesses tax credits and allow them to defer their payroll taxes so they can continue paying employees. Payroll taxes for the employer portion can be deferred 50% for up to one year, 50% up to two years. Employers, including those that have been ordered to close, would be eligible for a new payroll-tax credit as long as they keep workers employed through the crisis. However, employers that apply for small-business loans would not receive the credit.
Property Owner and Rental Assistance
Programs for homeowners that prevent foreclosure and provide mortgage payment relief are available from the federal government, states, municipalities, and private lenders. Now, the same help is ramping up for renters. Here's a few key takeaways:
- If your mortgage is backed by Fannie Mae or Freddie Mac, new guidelines may allow you to reduce or suspend payments for up to 12 months.
- In addition you will not be charged late fees or reported to credit bureaus.
- Foreclosure and eviction will be suspended for at least 60 days and include FHA backed loans as well.
- Additional help may be available after the forbearance period.
COVID-19 ResourcesKareo has compiled public, medical association, and journal COVID-19 resources below. We also encourage you to identify and leverage the resources of your state and local health organizations managing COVID-19 responses.
Help Us Help You
Our Customer Success Team offers one-on-one customer assistance by chat, email, or phone. As outlined, we don’t expect any material impact to our support capabilities in the event we are forced to implement further COVID-19 mitigation steps. Even so, there are certain things you can do to help us stay focused on the most critical support needs of our customers during this time:
COVID-19 ICD-10 Codes are now live in the Kareo Platform and are included in the following product workflows: problems, superbills, and claims.
Check out our Help Center to learn how to make the most of Kareo with free access to training, documentation and best practices.
Need support? These additional steps can help streamline the resolution process:
Submit a Help Ticket to utilize email with our support team to address your support needs. We can more easily distribute email cases in times of heavy volume than incoming calls.
Utilize Support Chat to engage on your issue, Monday-Friday from 5:00 AM to 4:00 PM PDT. Again, Chat is a somewhat more flexible support channel for our team than voice calls.
For support calls, avoid calling during the first few hours of each day which tend to be the most busy with the longest wait. Also, Mondays and Tuesdays are often busier than the rest of the week.
Visit our Status Blog to view any scheduled maintenance or current action item details. We also encourage our customers to sign up and receive updates.
During this unprecedented and uncertain time, Kareo’s Customer Success Team would like to thank you for your partnership and your understanding and patience as we implement our COVID-19 management policies. We’re working hard to ensure your practice or clinic can care for your patients and business without undue disruption.
Product ResourcesKareo’s best-in-class solutions help mitigate some of the issues created by COVID-19 and its impact to both your practice and patients. Here are just of few of the features available through Kareo to support your practice, staff, and patients:
This is a powerful tool to help practices engage with patients who can’t or don’t need to travel to the practice for treatment. Kareo Telemedicine is available to all Kareo customers through the Kareo web application and provides a comprehensive platform for virtual and secure face-to-face patient care. Kareo Telemedicine has been widely adopted by mental health professionals and other specialties interested in avoiding unnecessary office visits.Learn more
Patient Broadcast is a Kareo feature that allows a practice to quickly and easily notify patients of changes in a provider’s schedule or other important information including the need to reschedule appointments.Learn more
Kareo Patient Intake
Our Patient Intake solution allows practices to send forms for patients to answer ahead of an appointment. This is an opportunity for patients to share if they are exhibiting symptoms related to COVID-19, have recently travelled, or have been exposed to someone who may have exhibited symptoms. Practices can then reach out proactively and give patients info about what they should do if there are any concerns.Learn more
ICD-10 Codes for COVID-19
COVID-19 ICD-10 Codes (officially called “2019-nCoV acute respiratory disease”) are now live and included in the following product workflows: problems, superbills, and claims. We will also be adding the following codes: HCPCS codes U0001 and U0002 will be ready for the Medicare effective date of April 1st, 2020 and CPT code SARS-CoV-2 will be ready when the AMA approves a level 1 CPT code.Learn more
Business ContinuityKareo is exceptionally well prepared to manage through any disruptions created by COVID-19 in any of the regions in which we operate. Specific steps taken and plans include:
We have equipped our entire team of over 400 associates to effectively fulfill their roles remotely. To support this effort, we have audited the hardware, software, security, telecommunications and other equipment needed by each associate. Any gaps identified are being immediately addressed with the goal of a fully remote-capable workforce within one week. Most team members are fully equipped to work remotely today.
Our steps in leveraging this remote capability are as follows:
We have asked our team members to stay home if they feel ill or work from home if they have a sick family member. Our human resources team is coordinating closely with any impacted team members to ensure fact-based decisions are made about required testing or time period to return to work.
If any of the locations in which we operate face local actions to combat COVID-19, such as travel restrictions, school closings, or other mandates, we will immediately implement an as-needed remote work schedule for such location and impacted associates. We are well prepared for this possibility and do not foresee any operational impacts.
As outlined, we have made arrangements to go to a full remote work schedule if needed in any or all of our locations. As with partial remote work, we are prepared to deliver full operations in this scenario. There are steps you can take that will help us more effectively manage operations and continue to provide efficient support to our customers in this event. Please see the section “Help Us Help You” lower on this page.
Finally, the Kareo Platform is hosted within multiple, redundant data centers across the country. As a result, our hosted solution provides protections against natural disasters as well as other unforeseen disruptive events by allowing for seamless transition between the multiple data centers, enabling our ability to move customer traffic between them as needed. Further, we manage our infrastructure remotely today and any work from home staffing will have no impact in this area.