So, the date of ICD-10 implementation has come and gone. What can you expect? What trends do you need to watch? What questions do you need to ask?
Most practices saw October 1st come and go without much drama and that is because as of October 1, 2015, the revenue coming in the door is still based on ICD-9 (familiar territory) codes. Until the month of September claims have been fully adjudicated, there will continue to be a mix of ICD-9 and 10 reimbursements. There are somethings your practices can do to predict the success/failure of the transition within your practice.
- Begin tracking your high dollar procedures with DOS (dates of service) 10-1 and greater. How do the reimbursements compare with what you were getting for ICD-9 codes? Success doesn’t mean you will be making more money with ICD-10. Success means revenue neutral. Both higher and lower reimbursements need to be questioned. Talk to the carriers, make sure communication is clear and forthright. Understand any changes in revenue as a direct result of ICD-10 and decide on how to handle.
- Ensure all carriers are getting all claim runs with new ICD-10 formats and codes. This means taking a closer look at carrier reports available immediately after claim runs. Again, look for differences in responses. Look for rejected codes, look for possible carrier errors. Track carrier runs in detail to ensure success.
- As ICD-10 reimbursements come in the door, begin to predict your first month end reports based on what’s coming in the door. The important issue is no surprises; no surprises for Business office, no surprises for administration, no surprises for docs. People can handle what they know and understand. People panic over surprises. Don’t have any!
- Talk to coders, office personnel and docs continuously during the first couple of months. Who is behind? Why? What is causing frustration levels to increase? How can you adapt successfully to changes in expectations? What needs to change that you had not counted on? How do you solve the problems? Be proactive, be supportive and most of all be open. People will not communicate problems and issues if they think you are not open to their perspective.
This transition will challenge everyone. Maybe not in the beginning. Remember, it’s all about the cash. Keep your eyes on the cash and the processes used to collect that cash.