medical billing icd-10If you decided that ICD-10 can wait until 2014, your decision is now coming home to roost: 2014 is already flying by, and where are you with ICD-10?

In a recent poll conducted by KPMG LLP, the U.S. advisory firm, 50 percent of healthcare organizations reported that they had yet to estimate the ICD-10 impact on cash flow.

That’s pretty eye-opening, considering that most experts expect ICD-10 to have a significant impact on revenue for most practices. Some industry estimates project that productivity may decline by as much as 20-40 percent and denial rates may increase by as much as 100-200 percent.

Given that, what should you do?

Obviously, get started if you haven’t already. Delaying will only make things worse. Here are some suggested steps to follow:

  1. Evaluate the expected impact on your practice.

    As mentioned above, industry expectations are that ICD-10 will impact both productivity and revenue. What does this mean to your practice in terms of revenue and business operations? Any weaknesses in the practice are likely to be exacerbated by ICD-10, so now is a good time to address any financial issues with Days in Accounts Receivable and patient collections. Next, check with your vendors to make sure that they are or will be ready for ICD-10.

    Of course, you may be wondering about HealthFusion’s status with ICD-10. Good news: MediTouch EHR is already ICD-10 ready, with all ICD codes pre-programmed into our database – and of course we will continue to support ICD-9 until the very last payer has migrated to ICD-10 exclusively.

    Even more help is coming soon with HealthFusion’s enhanced ICD-10 TREE conversion tool. We understand that providers don’t need to code in ICD-10 for another 9 months, but the MediTouch team wants you have the opportunity to practice with these handy coding tools well before the deadline. As the industry leader in ICD-10 conversion, we are providing all of the tools required in plenty of time to make your switchover to ICD-10 seamless.

  2. Establish a plan, team and timeline.

    Once you’ve evaluated the potential impact on your practice, you should begin to develop a plan for implementing ICD-10, with strategies for minimizing the risks involved. Assembling a team that represents various functional areas within the practice is vital; be sure to include each area that will be affected, such as front desk, billing, and clinical. Be sure to have a physician sponsor on the team to encourage physician buy-in. With the team, build a timeline that addresses the needs of the different functional areas yet enables you to meet the deadline of Oct. 1, 2014. As you proceed through your plan, be sure to reevaluate to make sure the plan is still working and you are on schedule.

    Training will be a key component of your plan; be sure to plan different types of training for each functional area, as their needs will be different. AHIMA offers a useful timeline for training over the next nine months, which you can adapt to your needs.

  3. Protect your practice cash flow.

    With denial rates projected to increase by as much as 100-200 percent, your revenue can be significantly impacted by the switch-over. As hard as we’ve worked to prepare our EHR, and as hard as you work to learn the new code set, you have no control over payers’ readiness. Payers unfortunately have a history of not being ready for these types of transitions, as we saw with 5010. As a result, many experts are recommending that practices establish a line of credit well before Oct. 1 in order to avoid cash flow problems.

    You should also be aware that some experts predict that payers will try to renegotiate rates due to the change in codes. Be prepared for this and stick to your guns—the procedures and costs related to them haven’t changed, and the compensation should not be reduced.

You’ll find a large volume of resources (many free) available to assist you in the transition, and we’ve listed some below. The Workgroup for Electronic Data Interchange, which bills itself as a leading authority on the use of Health IT, is partnering with the Centers for Medicare & Medicaid Services and other public and private organizations, similar to the successful WEDI, CMS and industry collaboration during the 5010 implementation, to develop an ICD-10 Implementation Success Initiative. Just this week they published ICD-10: Top 10 Things To Do Now, a useful checklist of steps to prepare for ICD-10.

Most importantly, don’t be overwhelmed; remember that you don’t have to eat the whole elephant. You’ll only need to learn the codes you use most often, and you’ll have references for those you don’t. MediTouch’s own ICD-9 to ICD-10 conversion tool is available online, and you can make use of it now to start learning. Don’t let the size of the project intimidate you and keep you from getting started.

Resources