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Insights to guide your practice. 

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Now Available: "Road to 10" Resource to Help with ICD-10 Transition

by Kaitlyn Houseman on February 26, 2014

The transition to ICD-10 is going to change how you do business from registration and referrals to superbills and software upgrades.  However CMS has the following resources to help your practice prepare for the transition.

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Topics: Revenue Cycle Management, Practice Management, CMS, ICD-10, Coding

Less Than 10% of Physician Practices Ready for ICD-10

by Kaitlyn Houseman on February 10, 2014

Englewood, Colo., Feb. 4, 2014 – As the Oct. 1 compliance date to transition to the International Classification of Diseases, Tenth Revision (ICD-10) approaches for physician practices, MGMA research released today indicates that overall readiness for implementation continues to lag. Less than 10 percent of responding practices reported that they had made significant progress when rating their overall readiness for ICD-10 implementation, up only slightly (from 4.7 percent) since June 2013, when MGMA previously conducted research to assess readiness levels. The new research includes responses from more than 570 medical groups where more than 21,000 physicians practice.

“The critical coordination that must take place between practices and their software vendor, clearinghouse and health plan partners is simply not happening at the pace required for a seamless implementation. Very simply, ICD-10 is behind schedule,” said Susan L. Turney, MD, MS, FACP, FACMPE, MGMA president and chief executive officer. “MGMA continues to advocate on behalf of members and provides tools and resources to help practice executives make the transition to ICD-10 more cost effective and less disruptive to their organizations.”

MGMA urges the Centers for Medicare & Medicaid Services (CMS) to immediately take action to help ensure that physician practices can successfully undertake such a massive transition, including:

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Topics: Revenue Cycle Management, EHR, Practice Management, CMS, ICD-10, Coding

WEDI Survey a Snapshot of ICD-10 Implementation Status

by Kaitlyn Houseman on January 7, 2014

 “When compared to a similar WEDI survey given in February 2013, the healthcare industry has slipped further behind key ICD-10 compliance milestones suggested in the WEDI/NCHICA timeline,” the Workgroup for Electronic Data Interchange (WEDI) explained in a prepared statement.

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Topics: Revenue Cycle Management, Practice Management, ICD-10, Coding

CMS Phase 2 Denial Edits Will Begin January 6, 2014

by Kaitlyn Houseman on November 14, 2013

Several years ago, CMS mandated that payment for referral services would only be paid if the referring provider were properly enrolled in Medicare.  Due to industry pressure, the effective date for this policy was continually delayed to allow providers sufficient time to meet the enrollment criteria.  According to the following announcement, CMS intends to instruct their Contractors to turn on the ordering and referring edits on January 6, 2014.  

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Topics: Revenue Cycle Management, Medical Business, Practice Management, CMS, Coding, Denial Management

4 Major Risks with ICD-10

by Kaitlyn Houseman on November 13, 2013

According to CMS, 1 in 5 physician practices will see their Medicare denials double for up to 6 months after October 1, 2014, the deadline for ICD-10. Your practice does not have to be one of them. Get started early with planning for ICD-10.

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Topics: Revenue Cycle Management, Medical Business, Practice Management, CMS, ICD-10, Coding

The 5 Common Mistakes Made When Starting a Medical Practice

by Kaitlyn Houseman on November 8, 2013

1. Assuming it will be easy

You are excellent with medicine, and maybe a few other things. But no one can be good at everything.  Starting a medical practice entails much more than just seeing patients. Yes, there is a business side to starting a practice which is ultimately your business. There thousands of variables you haven’t even considered yet so do not be afraid to ask for help. 

Bringing in a practice start-up expert can save you time, money, and a few headaches.  Having the correct staff on board for your start-up can help you avoid some commin pitfalls that new practices can encounter so you have the best chance of building your new practice into a profitable, and long term solution for your specific situation.

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Topics: Revenue Cycle Management, Medical Business, Practice Management, Coding

Anderson Reveals “Scary” Truth About ICD-10 Test Results

by Kaitlyn Houseman on October 16, 2013

The North Carolina Healthcare Information and Communications Alliance executive director Holt Anderson revealed a ‘scary’ finding after some end-to-end ICD-10 testing.  Anderson made the announcement of their findings during the MGMA 2013 annual conference last week.

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Topics: Revenue Cycle Management, Medical Business, Practice Management, ICD-10, Coding

There's an ICD-10 Code For That?

by Kaitlyn Houseman on September 29, 2013

Burn Due to Water Skis on Fire? - There's an ICD-10 Code For That!

Struck by a Turtle? Walked Into a Lamppost? Hurt While Crocheting? Burn Due to Water Skis on Fire? – There’s a Code for that.

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Topics: Practice Management, CMS, ICD-10, Coding, Denial Management

Is Your EHR Your Certified Professional Coder (CPC)?

by Kaitlyn Houseman on September 26, 2013

The key to successful Electronic Health Record (EHR) adoption is not only selecting the right system, but ensuring you have the right people involved in the process. Many EHR’s pledge the reduction of coding staff because the EHR will allow you to swiftly document, accurately code your progress notes, and auto generate your coding. Sounds easy enough, right? What you might want to consider when listening to the sales demonstration is who is giving the demonstration. As a software vendor, do they have the experience of medical coders and reimbursement staff that have lived the tricks of the trade? Do they understand that sometimes submitting a clean claim requires more than automated claim creation and filing?

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Topics: Revenue Cycle Management, Medical Business, EHR, Practice Management, Coding

Recovery Auditors Aim at EHR Medical Practices

by Kaitlyn Houseman on October 11, 2012

Recovery auditors (RACs), which had been primarily focused on the billing activities of hospitals, will expand their scrutiny to examine physician practices, reported American Medical News.

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Topics: Revenue Cycle Management, Medical Business, Coding

Burn Due to Water Skis on Fire? - There's an ICD-10 Code For That

by Keith Lage on September 19, 2011

Walked Into a Lamppost? Hurt While Crocheting? Burn Due to Water Skis on Fire? – There’s a Code for that. This is an article from the Wall Street Journal that was posted on Sept 13, 2011 regarding ICD-10. Some may find this interesting/amusing. ICD-10 is a good reason for medical practice to partner with a professional billing service firm like GroupOne Health Source.

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Topics: Revenue Cycle Management, ICD-10, Coding

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