June 08, 2015
From October 1, 2015 onward, it will be mandatory for all provider’s offices in the United States to report their patients’ diagnoses applying the new ICD-10 coding. In other words, there will be a transition from the current ICD-9 coding to the new ICD-10. After the conversion date, the old codes will expectedly produce unexpected results and the medical claims carrying ICD-9 codes will not be processed due to invalid codes.
Under the circumstances, having uneducated or over burdened billing and coding staff can be very dangerous. If your billing staff is not up-to-date with the knowledge of coding rules or Federal regulations, you could put your practice in jeopardy.
According to reliable sources, billing & coding Staffing model will drastically change post-ICD-10. New coding will take longer time, especially when assigning codes for inpatient procedures. Some states would require both ICD-10-PCS and CPT for outpatient procedures coding. Multiple surveys highlight that there are worries for the shortage of qualified coders.
A recent survey by EHI and AHIMA reveals that as many as 31% providers plan to fill medical coding positions in near future to handle the looming billing concerns. This shortage is apprehended to be further compounded as many qualified coders may retire after ICD-10 is implemented. Difficulty in finding experienced and certified coders remains widespread. Practices with unique processes or specialization face bigger challenges.
One of the major reason for the difficulty in staffing is the recent changes in Medicare, Medicaid and third party payers. It is challenging for the provider’s offices to follow the proper protocol required by each payer. In order to maintain compliance, provider’s office must stay up-to-date with the latest changes in regulations and requirements.
Approaching the impending challenges through a combination of internal staff training and outsourcing could come across as a viable option, in order to minimize the need to invest heavily on recruiting or worry about staffing.
Generally speaking, the expenses of salaries, employee benefits, and investment in technology add up to much more than commonly required to be paid to a seasoned medical billing service. In the absence of an alternative, the practice can be severely stalled even when one employee gets sick or goes on vacation or takes leave of absence or quits altogether. Outsourcing ensures that it’s the responsibility of the outsourced company to support your revenue cycle management process year-round. Thus, the staffing worries shift away from you as well.
Not to mention, if you are constantly bogged down by the financial running of your office, it will be very difficult in providing excellent patient care. Instead, why not focus your time in providing quality care to your patients and leave the staffing worry to your outsourced partner. If privacy of your patients’ records is a concern, the Health Insurance Privacy and Accountability Act (HIPAA) requires that your outsourcing partner has rigorous privacy, security, and breach procedures as similar to medical practices. It is the responsibility of medical billing service to ensure that their billers and coders have received HIPAA privacy and security training. Their team of certified coders undergo thorough training and are equipped with the knowledge to appropriately submit medical claims.