Merely complying with ICD-10 mandate can prove risky for the financial health of your practice. If you fail to train physicians for ICD-10 documentation, coding will become difficult and it will lead to under-billing and underpayment. Even if you maintain documentation specificity, failing to follow-up with payers and complying with HIPAA-5010 will put your finances at risk.
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Co-ordination will have to be established with payers and outside services when planning for ICD-10 so that lack of key vendors, staff, vendor preparation and budget doesn’t pose a hindrance in meeting the deadline.
- Only coders won’t require training. Staff will have to be trained to handle more phone calls, patients and workload. In case they are not well-trained, practices will have to face fraud and abuse cases related to ICD-10 codes transition
- Lack of readiness might lead to payer delays which will hit your revenue cycle. You will have to talk to the payers and verify their readiness to avoid financial risks
- Software and consultants will be required to handle the detailed codes and it will cost money
- Inconsistencies will have to be mapped because system changes will take time
A lot of planning and diligence will be required to avoid the risks associated with the above-mentioned challenges. There are even some hidden risks related to ICD-10 conversion that will cause issues to medical practices..
- Payers will become extra careful for coding errors which will lead to denials and appeal of the denials. This will result in delayed payment to practices
- Banks will become more conservative in lending as they know that ICD-10 conversion will result in revenue loss and disrupted cash flow
- Payers will tighten reimbursements and require more detailed data which will create documentation pressure on physicians
How can practices survive these risks?
Do you have sufficient time for creating implementation plans, hiring new staff, training existing staff or talking to EHR vendors and payers? Does your practice have enough money for implementing system changes and other ICD-10 requirements? If you don’t want to lose out on revenue due to lack of time and money, outsourcing would be the best option.
Specialized medical billing services will offer effective solutions to make ICD-10 transition smoother. A team of well-trained coders and latest technology will be used by the billing partner to handle your coding and billing requirements. The need to hire and train new coding staff and upgrading existing systems for ICD-10 will be eliminated as a separate team will be handling these tasks with precision.
Medicalbillersandcoders.com offers streamlined medical billing services to practices across 50 states in the US. We have helped practices in smooth transition to ICD-10 by suggesting effective solutions, addressing challenges related to the new coding system, handling claim processing, denial management and account receivable through accurate coding. Your in-house coders can also benefit from our training program that prepares coders for the new coding challenges. While we eliminate the risks associated with ICD-10 conversion, you can concentrate on patient care.