Did you know that if the CMS fails to process one in five Medicare claims properly, it will lead to serious financial challenges for healthcare organizations? According to the industry experts, if CMS doesn’t develop suitable contingency plans, the ICD-10 transition might prove to be detrimental for various medical facilities, especially small practices. The impact of the transition could lead to loss of multi-billion dollars and also result in challenges associated with access to care for the Medicare patients.
Industry facts
| According to the latest ICD-10 end-to-end testing results, Medicare claims that the acceptance rate might decline from 97% to just above 80% if the new coding system is implemented before the October 01 deadline this year |
| Small physician practices with one to five physicians might find the ICD-10 testing more challenging compared to large healthcare facilities |
Need for a Contingency Plan to Reduce Revenue Loss
The American Medical Association (AMA) and 99 other specialty groups from all over the US have requested CMS to develop a contingency plan for the anticipated revenue loss once the new coding system is implemented. According to the AMA, contingency plans will help to reduce unnecessary administrative tasks and save thousands of dollars.
Are you Prepared for Risks of the ICD-10 Transition?
Healthcare organizations need to be prepared for some major risks associated with the ICD-10 transition, such as:
Have you Applied for ICD-10 End-to-End Testing?
Various training sessions, resources and ICD-10 testing opportunities are being offered by the CMS to help providers prepare for the transition. With end-to-end testing, CMS encourages healthcare providers to participate in the ICD-10 testing conducted by their vendors, clearinghouses and other associations. The next phase of testing is scheduled on April 27 through May 01 this year for which providers have submitted applications till January 21. If you wish to participate in the third and the last testing phase scheduled for July 20 through July 24 then you have time only till March 13 to register on the CMS website.
No Dual Coding Relief for Medical Facilities
As per a statement released by the CMS in February 2015, providers will not have to perform dual coding starting on October 01, because most payers and providers have already adopted IT systems that permit only ICD-10 codes.
How can MBC Help Ensure ICD-10 Readiness?
There is no doubt that CMS resources are helpful and the news of scrapping the dual-coding from October 01 has come as a relief to healthcare facilities, but when it comes to ICD-10 readiness, how many practices are actually prepared? Many providers across the US are relying on MedicalBillersandCoders.com’s expert coding and billing services to sail through the ICD-10 revenue challenges. MBC’s coders are certified and experienced in handling ICD-10 codes for over 40 medical specialties. Since a dedicated team of billing and coding specialists will submit error-free claims post ICD-10, healthcare providers can eliminate their worries of cash flow disruptions and focus only on core patient care.
