Revenue Cycle Management Blog | GroupOne Health Source

Avoiding Cash Flow Interruptions from ICD-10

Written by Kaitlyn Houseman | June 10, 2015

The time has come for making the transition from ICD-9 to ICD-10, with the deadline being October 1, 2015. The old ICD-9 system is outdated and insufficient for meeting the demands of a healthcare system that uses electronic health records and sharing of information. With greater detail on things like laterality of a condition, ICD-10 documentation will ultimately provide much richer health data that conveys more information than the old codes.

Some specialties will experience greater impact from ICD-10. For example, orthopedics will have to make a more sweeping transition than many other specialties. Not only will the new codes include laterality, for example, injuries will be grouped by anatomical site rather than by type of injury. Nobody disputes the effort that will be required to switch from ICD-9 to ICD-10, but once the transition has been made, results will include better revenue cycle management and more efficient medical billing. Here are some ways your practice can avoid cash flow difficulties due to the ICD-10 transition.


Start With a Roadmap

Planning the changeover is essential to success. If you don't know where to begin, the Centers for Medicare and Medicaid Services (CMS) offers Road to 10: The Small Physicians Practice's Route to ICD-10, which is a collection of online resources that steps you through the phases of the conversion, such as training, updating processes, communicating with vendors and payers, and testing your system before it goes live.

Ensure Adequate Staff Training

Staff training will be essential to avoiding revenue cycle management headaches with the change to ICD-10. Personnel who assign codes or verify the assignment of codes, clinicians, and medical billing personnel will all need some degree of training. For some personnel, awareness training may be sufficient. Those who assign codes or who use coded data for reimbursement, research, or statistics will require more intensive training. One way to gauge the need for training is to have your coders practice assigning ICD-10 codes for existing encounters. This can highlight which new codes will have the most impact on your particular practice and give your staff an idea of what to expect.

Test Your Systems Beforehand

Testing should happen after you have communicated with your vendors, payers, processors, clearinghouses, and other third parties who will be affected by the ICD-10 transition. At first, you will want to test your systems internally to ensure that everything works as it should within your facility. After that, you should test your systems with your various partners to discover if there are glitches, unanticipated slowdowns, or other problems. The more of these you can resolve before October 1, the easier your medical billing and revenue cycle management will be once the deadline passes.

 

Prepare Your Budget

Even if you have taken all the right steps toward a successful ICD-10 transition, it is important that you budget for the transition and that you ensure you have sufficient cash on hand or a healthy line of credit to cope with possible cash flow issues. A single issue with one payer or one clearinghouse can seriously complicate revenue cycle management and slow down medical billing completion. Suppose that one insurance company stops paying because of a technology glitch. Even if that insurer only represents a fraction of your revenue, it can seriously affect your ability to take care of bills and payroll.

Conclusion

Ultimately, ICD-10 should be better for all parties, including practices, insurers, doctors, and patients. Getting there will be a challenge, but with clear planning, good training, outstanding communication, and thorough testing of systems beforehand, you should be able to avoid major complications of revenue cycle management and keep cash flowing. You can expect a productivity drop from your medical billing staff when the deadline arrives, based on experience with ICD-10 transitions in other countries. But if you ensure you have sufficient cash on hand or adequate lines of credit, you should be able to cope with the growing pains as expediently as possible.

GroupOne Health Source is operated by highly skilled revenue cycle management specialists. With over 20 years of full-service medical billing, transcription, technology, and consulting experience, GroupOne Health Source is ready to help you as your practice or facility makes the transition to ICD-10. Contact GroupOne at services@g1hs.com to learn how to improve your revenue cycle management.