revenue cycle management for icd-10
Post on 28-Jan-2016
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1
Rich FlahertyVP of SalesMDeverywhere
Revenue Cycle Management for ICD-10
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Agenda
• Why ICD-10
• Practice implications
• Partner for success
• Asking the right questions
• Key takeaways
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WHY ICD-10?
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Pros and Cons of ICD-10 Delay
ICD-10 Delay Creates Headaches
Senate Passes One-Year SGR Patch, ICD-10 Delay Bill
ICD-10 Delay: Politics Versus Policy
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Much Has Changed Since 1979
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ICD-10 Is Necessary
• Greater specificity, improved tracking
• Longer codes, larger code set
• Improved monitoring of global health trends
ICD-9 ICD-10
Pressure Ulcers 9 codes 150 codes
Angioplasty 1 code 854 code
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IMPLICATIONS FOR YOUR PRACTICE
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Implications
• All aspects of patient encounter will change
• Disruption in operations and payment streams
• Loss of productivity
• Software breaks
• Staff turnover
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Sobering Facts
5xHFMA prediction on increase in denials.
$50-200KEstimated spend on
transitions costs.
80%Practices will need
to upgrade software.
6 MonthsRecommended
amount of cash flow in-house.
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SURVIVING THE TRANSITION
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Minimizing Impact
• Don’t underestimate the degree of change
• Invest in training
• Assess documentation procedures
• Engage staff early
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Consider an RCM Partner
• Choose and RCM partner invested in ICD-10
• Leverage resources and capabilities
• Leverage operational scale, technical expertise
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FINDING THE RIGHT PARTNER
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When Will Your System be Compliant?
1/3 ICD-10 Ready Now 2/3
Not Ready
27%Would not have been ready by Oct. 1, 2014
deadline.
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Are There Additional Costs?
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Customer Support & Training
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GEMs & Crosswalk
• Supplement with extended search capabilities
• Natural language parsing
• Code set selection based on payor readiness25%ICD-9 codes
have an exact match to ICD-10
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Dual Coding
• Support simultaneous use of codes for training
• Benchmark productivity for live implementation
• Testing with outside organizations
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External Testing Strategy
National Testing Week March 3-7, 2014
Claims tested successfully with 100% accuracy and
without rejections.
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Key Takeaways
• ICD-10 is inevitable and necessary
• Keep the pedal to the metal
• Don’t stop your ICD-10 preparations
• Partner for success
• Ask the right questions
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About MDeverywhere
• Leader in Revenue Cycle Management
• MicroMD Strategic Partner
• Serving 7,000 physicians, 40+ specialties
• MDe clients increase collections 10-15%
• Decrease denials by 95%
• NCQA CVO certified
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Thank You
www.mdeverywhere.comquestions@mdeverywhere.com
631.232.4260, option 4
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