Should a practice outsource billing to prepare for ICD-10 Challenge?
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This document discusses the challenges practices will face in transitioning to ICD-10 coding by the October 2015 deadline and the options for getting help. It notes that ICD-10 will impact billing, documentation, coding and revenue. Practices need to assess their vendors' and their own readiness, including staff training. If unprepared, outsourcing billing to a specialized company that provides ICD-10 expertise may help practices avoid revenue loss and claim denials. The presentation evaluates in-house vs outsourced billing and provides tips for selecting an outsourcing partner. It promotes one company, CureMD, that offers ICD-10 consulting, billing services and software to help practices with the transition.
Should a practice outsource billing to prepare for ICD-10 Challenge?
- 1. ICD-10 Challenge? Should a Practice Outsource Billing to Prepare for Your Webinar will begin shortly... #CureMDWebinar@Ken_Edwards01 We will be tweeting live
- 2. Presenter Ken Edwards Senior Billing Manager, CureMD
- 3. Topics to be covered Impact of ICD-10 Vendor Readiness Practice Readiness Outsourced vs in-house billing What to look for in an ideal RCM partner for ICD-10? . . . . . ICD-10
- 4. Q. What is your top most concern for ICD-10? a. Physician documentation post ICD-10 b. Readiness of billing department c. Readiness of your EHR vendor
- 5. The change that will shake the healthcare industry Claim errors will increase by 7% . . ICD-10 changes EVERYTHING
- 6. 40% increase in A/R days (CMS) 200% rise in claim denial rates (CMS) Justify the medical treatment Complex denial appeals .... Revenue and cashflow impact of ICD-10 Source: Centers for Medicare and Medicaid Services
- 8. What should you ask your current vendor? What is your time frame for implementation? What tools, training, and support will you provide to me and my staff so we can prepare our practice for ICD-10? Will your products be ready for the ICD-10 compliance date? Will both your EHR and practice management system solutions be able to support ICD-10? When will you be able to show me how ICD-10 will work in my EHR and practice management solutions? Will your system support both ICD-9 and ICD-10 codes? How much will you charge to upgrade to the new ICD-10-compliant solution? Does training cost extra? Will I need new hardware to accommodate your ICD-10 upgrade ? Will you help me test my ICD-10 compliant EHR and practice management system with my payers? ICD-10 Readiness Cost Implementation
- 9. If your EHR Vendor does not respond in a timely manner or if the responses you receive are vague Consider Switching
- 11. ICD-10 will have a direct impact on physicians through: Physician quality profiles – mortality and morbidity Physician utilization profiles – efficiency of treating patients Physicians’ current and future evaluation and management levels, including pay for performance Daily workflow – (if ICD-10 is not properly implemented) . . . . Are you up for the challenge?
- 12. It is estimated that physician productivity will decrease by 10%-20% due to ICD-10 documentation
- 13. ICD-10 will infiltrate your domain Source: American Academy of Professional Coders Physicians Nurses Lab Billing Coding Front Desk Managers Clinical Area
- 14. Is your Billing department up for the challenge?
- 15. Where do your denials stand? Denials > 4% = poor performance Cost per denial = $30 Benchmarking important KPIs ... Administrative time Patient care 1.
- 16. 16 hours on ICD-10-CM 24 hours on ICD-10-PCS 10 hours on practice implementations (AHIMA) Started training coders?2. Source: American Health Information Management Association
- 17. Hiring in-house billers? Professional coder costs $50,000.3.
- 18. A/R management? Exceed 120 days Periodic reports Specialty-level comparison . . . 4.
- 19. Resources for PQRS and MU Stage 2? 5.
- 20. Is your practice on track ? 20152014 Oct Nov Dec Ongoingpracticebefore“golive” Ongoingpracticebefore“golive” D E A D L I N E O C T 1 2 0 1 5 PLANNING Identify resources Create project team Assess effects Create project plan Secure budget COMMUNICATIONS Inform staff Contact vendors Contact payers Monitor vendor prep Monitor payer prep TESTING High-level training for test team Level 1: internal Level 2: external COMPREHENSIVE TRAINING Documentation Coding O c t N o v D e c J a n F e b M a r A p r M a y J u n J u l A u g S e p
- 21. If your practice is not prepared for ICD-10 Consider Outsourcing!
- 22. 6% increase in revenue for practices with outsourced billing. Nearly 90% of solo and small practice physicians with in-house billers and collectors said they expect to outsource most or all their billing functions for ICD-10. Fact Source: Black Book Rankings Survey 2014 In-house vs outsourced In-house Pros Cons Outsourced Retain Control Less Expensive Close Proximity Transparent Enhanced Consistency Liabilities Hands off Staff issues Hidden Fees Higher costs
- 23. Before outsourcing billing and collection services, practices should carefully evaluate the company to minimize risk and lost revenue. Make sure your billing service provides you with a HIPAA-compliant Business Associate Agreement—and read it carefully. Don’t assume that billing service employees are up-to-date on federal regulations; ask about employee training. Don’t seal the deal with a handshake; make sure you have a contract that spells out the terms of service and includes details on indemnification, insurance, and termination. . . . . Choose the right billing vendor Do not select a billing company solely on low rates without considering the risk attached to it
- 24. What is your strategy for ICD-10 so far? a. Go at it alone b. Outsource to a billing company c. Bring an ICD-10 consultant on board
- 26. ICD-10 ready software We updated our cloud-based EHR in 2014, giving our providers ample of time to practice new codes before the deadline. Our in-house experts will assist you throughout the conversion process, helping you with training and successful implementation of ICD-10. ICD-10 consultation team Still anxious about your prospects for successful ICD-10 conversion? We have a perfect solution for you. Give us your medical billing and concentrate on your patients. Billing Service
- 27. Session QA&
- 28. Request a demo to see how CureMD can facilitate your practice for ICD-10 Get in touch with our ICD-10 experts at (212) 852 0279 ext 384 For further inquiries regarding ICD-10, send us an email at healthit@curemd.com Need Help?
- 29. Thank you Look out for our email, containing the webinar recording and free ICD-10 ebook