You Received Your PPP Check. Now What?

By Bridgitte Shen Lee, OD, FAAO, FBCLA

As of April 22, 2020, there are nearly 2.6 million confirmed positive COVID-19 patients in the world and about 820,000 in the U.S. Texas had more than 20,000 cases and Houston around 7,300 cases. Houston is under a “Stay Home – Work Safe” order from March 24 through April 30.  Our practice, Vision Optique, is currently scheduled to see patients on Monday, May 4, 2020, unless Houston extends its “Stay Home” order.

The Paycheck Protection Program (PPP) is intended to provide small businesses with funds to pay up to eight weeks of payroll, rent, interest and utilities. Applications opened April 3, and the $349 billion was fully deployed by April 16. Another round of PPP funding was expected to be signed into law.

We are very grateful that Vision Optique is among the approved loan recipients. Our eight weeks run from April 16 to June 10, regardless of when our physical office reopens. To make effective use of the loan, we are leading our team through a 2.5-week preparation period. We are following the intent of the PPP by bringing back the entire team of three doctors and seven team members at full time pay for eight weeks through June 10.

Here is our timeline.

March 23 – April 30: Physical Office Closed

• Staffing: combination of furloughs and pay reductions (including doctors)
• Virtual office: calls and emails answered daily by rotating team members
• Medical emergencies: medical consults by phone and in-office if needed to treat emergency

Saturday, April 18: Zoom Team Meeting

• Reviewed PPP loan details and overall work plan in stages: before May 4, through June 10 and after June 10
• Explained reopening schedule adjustments for May and June to prevent and minimize infection

1. Doctor: only one doctor sees patients each day, with each doctor working two days per week in the clinic
2. Team members: divided into two teams, each team working three days in the office
3. Patients: scheduled one per hour with strict disinfection before/after
4. Operation: running both physical office and virtual office

April 20 – April 30: Preopening Preparation by Role

Owner doctors

1. Oversee physical office preparation
2. Plan overall strategic operation and marketing
3. Assign detailed duties, responsibilities and training goals
4. Review accounts receivable and optical planning with manager

Associate doctor: working from home

1. Answer medical consults and emergencies
2. Assist with external and internal marketing materials and communication details
3. Oversee team members with their assigned duties
4. Schedule/coordinate online training: optician and staff training on ophthalmic lenses, contact lens, nutritional supplements, cosmetics and dry eye

Office manager/senior optician: only one in office at a time

1. Enter insurance checks and file contact lens purchases that used vision insurance during the closure
2. Review accounts receivable for both medical and vision insurance
3. Review frame inventory and help owner doctor formulate plans through June
4. Review credit due for ophthalmic lab and contact lens purchases
5. Curbside dispensing of phone orders, if needed

Team members: working from home

1. Continue answering calls and emails
2. Review schedules – only comprehensive exams for doctors; specialty contact lens and soft contact lens insertion/removal teachings for staff; dry eye treatment procedures only on Thursdays; all therapeutic calls to be scheduled first for telemedicine consult before being seen in office
3. Accomplish assigned duties and training goals

April 20 – April 30: Physical Preparation

Securing Medical Supplies

1. Masks: “eye themed” cloth masks for team, disposable masks for patients (require searching)
2. Gloves: ideally fresh pair per patient (be aware of back order)
3. Shields: acrylic “sneeze guard” to be installed at front desk; shields for all slit lamps; eye shields and face shields
4. Floor tape: safe social distancing marks leading to front desk
5. IOP devices: review non-Goldman tonometry option
6. Alcohol (70%): disposable wipes, solutions, Clorox

May 1 – May 2: Soft Reopen

• Physical office: one doctor/half team members each day
• Virtual office: calls, emails, scheduling, insurance authorizations

How we take care of our patients will change as a result of the COVID-19 pandemic. Until effective testing, contact tracing/tracking and a vaccine are available, we must place safety as a top priority for patients and our team members.

Below are some suggestions on creating a virtual office (while your physical office is closed) and getting in line for the second round of PPP funding.

Recommendations of Tasks to Accomplish During Closure

1. Set up secure remote access to your EMR system and set up online credit card processing
2. Transfer one of your phone lines remotely and assign one staff member to answer all calls
3. Identify and sign up for a contact lens ordering and management system

Recommendations for 2^nd Round of PPP Applications

1. Use a local or regional bank that is already SBA-certified and with which you have an existing banking relationship
2. Ask the bank for its own Excel calculation sheet and have all the forms/documents prepared and ready to submit
3. Communicate and confirm with the bank regularly

This is an incredibly stressful time for doctor owners, employees and patients alike. Remember it is only temporary, health and safety should remain our top priority, and we will all get through this.

Reach Dr. Shen Lee at bshenlee@gmail.com

@drbridgitte @visionoptique