Billers & Coders to Help Practices Assess the Financial Impact of ICD-10

The implementation of ICD-10 coding means facing the challenges of an unknown entity. When it comes to facing the financial aspects of ICD-10, billers and coders have to be very cautious while adopting this transition.

It is important for the billers and coders to help practices consider the financial aspect of transitioning to ICD-10 coding, or else it could prove to be the great disaster for the practice. As billers and coders act as a catalyst in the ICD-10 implementation, it is crucial for them to understand the financial aspect of ICD-10 coding and help physicians invest profitably in the areas that will impact their revenue most.

Industry Standards State

Financial impact of ICD-10 Reason
Conversion to ICD-10 can cost the health care industry between $475 million and $1.5 billion over ten years Staff training Loss of productivity Changing systems
Over the same ten years, the health care industry would gain between $700 million to $7.7 billion Cost saving

How will transition to ICD-10 affect the overall cost?

Predicting the outcome of transitioning to ICD-10 coding system is not easy. It's near impossible to tell exactly how it will impact revenue. No one's really sure how much training will be enough, and how payers and providers will cope with it. Let us explore some of the facets where it might affect the practices.

Staff Training:

Upgrading the practice to ICD-10 transition will require substantial investment on training programs for coders, medical staff, nurses and allied health providers, where the staff will have to be trained to map and load codes, revise system interfaces, develop new reports, map dual coding systems, and retrain users. For this, there would be aggressive training programs for staff which may affect clinical and operational efficiency. This would require the practice to invest heavily in such training programs, which would impact their revenue.

Loss of Productivity:

Due to the transition from ICD-9 to ICD-10, it would be inevitable for the practices to contend with loss of productivity. Insufficient understanding of the new code sets of ICD-10 would result in major loss of productivity due to increased claims denials. Such claims denials will result from deficient health information management/coding, case management, claims processing and follow-up, researchers and decision support.

Changing Systems:

Conversion to ICD-10 will result in increased capital cost outlays due to modernization of existing practice management systems. Implementation of ICD-10's complex code structure means added cost for implementing changes in EHR, billing systems, upgrading/replacing multiple systems. Moreover, there would be additional cost in reporting packages and other decision-making and analytical systems.

How can medical billers and coders help practices assess the impact accurately & reduce costs?

One of the major concerns associated with the transition is the impact of ICD-10 coding on the revenue cycle. Implementation of ICD-10 coding brings with it multidimensional facets of investment. It is difficult for the practices to cope with these financial implications of ICD-10 coding that effectively on their own. Hence, it is essential that the medical billers and coders take lead in helping physicians to estimate cost outlays associated with technology, system, training, and process modernization.

Medical Billers and Coders can...

  • Advise physicians on the benefits of early training to reduce the impact on clinical and operational efficiency
  • Help physicians eliminate the inherent deficiencies in billing and coding process, and prevent negative impacts to reimbursement and cash flow
  • Help practices in upgrading the change in the system in congruence with the ultimate billing and coding needs

If medical billers and coders work along with physicians, they can successfully combat the financial impact of ICD-10 transition.– the largest consortium of medical billers and coders across all 50 US States is constantly updating their coders’ knowledge with ICD-10 transition techniques. Our unique training program on ICD-10 transition offers webinars, forums, and online learning materials, and latest updates – works towards making this transition much simpler and much more beneficial for both practices and the medical billers and coders.

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