Guest post by Alex Tate, digital marketing specialist, content strategist and a health IT consultant at CureMD.
Most conductors are sounding out the last call for passengers to climb aboard the ICD-10 train. Although the trains won’t reach full steam until Oct. 1, 2015, the test runs will commence shortly. You’re probably wondering why passengers have to sit through these test runs, right? This is because the journey will last for at least 10 years, so everyone needs to get accustomed to the environment of this locomotive.
Your practice is the train, you are its railroad engineer, the conductor is your practice manager, but who are the passengers? Surely not the patients; they don’t need to apply the codes, do they? The answer to both questions is no. The passengers are your medical billing software vendors, you clearinghouses, your payers, and most importantly – your billers and coders.
If you haven’t started inquiring if these stakeholders and their systems will be ready before time, you could suffer from huge reimbursement disruptions once claims become dependent on these new codes. However, you still have time to get your engines running, and here’s what you need to do:
Contact your medical billing vendor
The first passenger on your train, irrespective of the number of trolleys you’re carrying, is your practice management (PM) or medical billing software vendor. This is because you need to inquire if your billing software is ready for the new codes. If not, you’ll not be able to get your claims through because they’ll contain defunct codes.
Additionally, you must also inquire if the vendor has a clear mapping process for ICD-10 conversion. If upgrades cost extra, or if you’ll need more training, you should have that in mind beforehand.
Lastly, ask them when you’ll be able to begin internal and external testing using these new codes, and if they have any recommendations for streamlining the process.
The debate rages on, despite the Department of Health and Human Services (HHS) issuing a rule finalizing Oct. 1, 2015, as the final date for ICD-10 implementation. Why? Because they said there would be absolutely no more delays last year. And the year before that. It’s kind of like a parent who doesn’t follow through with consequences in childrearing. If the child gets away with it once, they’re going to try again. I predict rages against the machine until midnight on Sept. 30, 2015.
The Delay
I was in the field, one day into a two-day boot camp, in Connecticut. UConn had just made it into the Final Four, and the hotel bar was filled with revelers watching ESPN. I was in my hotel room, on the phone with my husband because the hotel didn’t have C-Span. He gave me a blow-by-blow count of the votes required until the SGR “doc fix” bill would pass because, at the last minute, the bill had been revised to include language affecting ICD-10 implementation.
If it passed, doctors’ reimbursements would not be cut by 24 percent, but ICD-10 would be delayed by at least a year. My husband is a surgeon, so we had a stake on both sides of the fence … or aisle, I suppose. Of course, it passed — it always passes. But what did that mean for all the people I’d taught in the past months, and what would that mean for the class I had to face the next morning, smack dab in the middle of their training? I expected to see my class members just as disheartened as I was and worried about the energy level of the second training day.
It turns out I didn’t even need to bring cookies. Nobody was disappointed. In fact, there seemed to be a collective sigh of relief. And these were the people I thought were ahead of the curve on implementation.
So, I took a poll:
Did they think people not ready for ICD-10 in 2014 would be ready in 2015?
No.
Did they think people who were almost ready would spend the year getting extra-ready?
Guest post by Vijay Gaware, associate practice manager, MphasiS.
For the healthcare industry, one of the most hard-hitting changes in recent years is ICD-10. One of the most complex regulatory mandates, transitioning to ICD-10 encompasses providers, payers and claims clearing houses. As a result, the transition from ICD-9 to ICD-10 has a far-reaching impact on any organization’s structure, affecting people, processes and technologies.
With October 2014 fast-approaching, healthcare organizations are switching gears and racing to achieve ICD-10 compliance.
Organizations across the board are adopting various measures, such as analyzing the impact, redesigning the architecture, developing the systems, and, finally, testing to ensure ICD-10 compliance.
