Revenue Cycle And ICD-10: Industry Insights To Share With Your Organization

It’s entirely too easy in your day-to-day work to look past preparations for ICD-10 that you could be implementing right now.

We’ve selected the articles below to walk you through an introduction to the impact of the coding system delay on implementation, and into discussions around strategic and tactical decisions for your organization.

Rev Cycle And The Delay, An Overview

This article from Health Management Technology explores the often overlooked impacts of transitioning to ICD-10 on revenue cycle processes. It highlights key areas of impact including eligibility and utilization management, clinical documentation, contract management, and contracts and reimbursement data based on ICD-9. The article also emphasizes the importance of revenue cycle specific training around the transition, with an emphasis on medical coders, physician competence, and advanced clinical documentation technologies.

AHIMA Offers Advice

The American Health Information Management Association takes a deeper look at the impact of the transition to ICD-10, broken down into front, middle, and back-ends of the revenue cycle process. On the front end, it explores patient access and denial management, pre-certification, case management, medical necessity, among other topics, including unintended impact on finances and the importance of contract management. In the middle it explores charging and pricing, physician documentation and electronic order entry, along with computer-assisted coding. The article also addresses back-end concerns in the two categories of billing processes and cash collections and reimbursement. Read the full article here.

Ebook On Managing The Delay

The ICD-10 delay is a hotly contested topic, and with the new implementation almost a year away (October 15, 2015), healthcare organizations will need specific strategies for navigating their revenue cycle management processes until then. This eBook (available for download here) from Healthcare Informatics, and sponsored by Greenway Health, will give readers insight on RCM relevant topics including,

• Top myths and rumors around policies and coding
• Steps to monetize the ICD-10 delay
• Optimizing RCM operations through tech and processes
• Adjusting costs related to system overhauls and new technologies.

Is Outsourcing Rev Cycle The Answer To ICD-10?

As hospitals are increasingly turning to outsourced revenue cycle solutions as an answer to the potential losses of the ICD-10 transition and delay, the question of whether the process can actually mitigate losses is being posed by EHR Intelligence in this article. A whopping 20 percent of hospitals that have recently outsourced their RCM processes still fear bankruptcy or closure if their solutions aren’t the most up-to-date available. These concerns are bound to increase as the challenges of an ICD-10 implementation loom.

Mitigating Impact Of The Delay

This article from RevCycle Intelligence, covers three critical points in navigating the financial impact of the ICD-10 delay. The steps include measuring financial impact, leveraging clinical documentation improvement, and preparing for systems conversion and testing. As Erik Newlin, VP of EDI Platform & Compliance at Xerox (and co-chair of the ICD-10 Assessment Workgroup at WEDI) says, “You may have already checked the box and said, ‘Hey, I’ve passed this gate,’ but the reality is with the shift in timeline you may very well have to repeat various aspects of your testing strategy and other aspects of your implementation plan.”