a multitude of resources at our fingertips. You don’t have to reinvent the wheel. Access the webinars on demand, previous articles in Billing, educational articles and downloads offered by CMS, and the software, consulting services, computer-assisted coding, and other resources offered by vendors. Look for specialty-specific resources that will benefit you and your clients. The HBMA message board and other specialty boards contain a wealth of information. Below is a four-step process that will help ensure the success of your own internal ICD-10 implementation: 1. PLAN: Appoint an ICD-10 project team, preferably including one C-level staff member as well as coders, billers, and IT staffers. Ensure members of this team understand the significance of the project. Plan a realistic budget and confirm the commitment of all internal and external players. Contact vendors, clients, hospitals, and clearinghouses to determine their plans. Develop, outline, and begin execution of your plan of action. Stick to your timeline. 2. ASSESS: It is crucial to identify the impact of ICD-10 on your business processes. Identify all transactions that could or will experience delays, such as receipt of data from clients, coding (if you provide coding services), claim submission and reimbursement, eligibility verification, contracts, analytics, and IT and software updates. Be persistent when talking with vendors regarding their readiness. As you assess your own internal processes, keep your client base in mind. Studies show that some specialties, such as radiology and orthopedics, will be hit harder than others. Clients utilizing electronic health records (EHRs) may fair the best, depending on the software used. Specialty-specific studies by RadPayor Inc. show that radiology may be hit with a 19 to 42 percent loss of revenue until documentation improves. At a time of reduced revenue, many providers may decide to outsource rather than increase their coding or billing staff. With proper planning, billing companies knowledgeable in various EHR choices, as well as those utilizing specialty-specific autocoding programs shown to improve clinical documentation, will be in a position to offer immediate assistance. 3. EDUCATE: Accurate clinical documentation will be imperative, requiring engagement by your clients/physicians as well as their mid-level providers and medical assistants. However, front desk staff, coders, and billers within your office, as well as your 24 HBMA BILLING • MARCH.APRIL.2015 clients, will play an equally important role in the success of your client transitions, which equates to the success of your transition. Accurate, detailed demographic and clinical documentation will be required for successful claim submission. Education will be an ongoing process. 4. IMPLEMENT: Develop a project schedule and stick to it, meeting regularly to address progress. Execute your plan diligently. Continue to review your budget and cash flow projections based on your assessment review, and revise if needed. Remember, if your client’s cash flow is disrupted, the same will hold true for you. Advise clients to secure a credit line to cover six months As you assess your own internal processes, keep your client base in mind. of expenses to offset any disruption, and secure one for your own protection. Don’t wait until your revenue stream is interrupted. Your financial institution is more likely to give you favorable rates and credit lines if you secure your credit line while you have a steady revenue stream. If you are still unconvinced to take action, consider this: if CMS implements ICD-10 on October 1, 2015, in less than one year, every healthcare provider will have to upgrade or replace their billing management system, outsource, or retire. That means every hospital, clinic, office, surgery center, nursing home, hospice, home health service, pharmacy, dentist, insurance company, and Medicare and Medicaid provider. According to RadPayor Inc., that’s 823,687 businesses and 2,572,989 providers affected on the same day. ICD-10 is coming your way. Don’t wait to seek help on the same day as 2,572,989 other providers – the helpline will be busy! ■ Dorothy Henslee, CHBME, is the owner of Millennia Information Systems LP, serving clients across the US. Dorothy brings 20 years of revenue cycle management and consulting to her clients. She may be reached at dorothy@applemedicalbilling.com or at 903-465-9508.
Billing_MarApr15
To see the actual publication please follow the link above