3. Understand why and when you will need to hire additional staff
If you haven’t thought about this already, you may be seriously behind the eight ball. According to ICD-10 Monitor, April 1, 2015 was the deadline for increasing staffing levels to meet the challenges that will be produced by ICD-10 transition. It’s estimated that a six-month head start will help organizations adequately prepare for the complexities of coding and expected drop in coder productivity.
Studies indicate that productivity will decrease by 50 percent and will not return to normal for at least 6 months. As the article from ICD-10 Monitor points out: combining this productivity decrease with overall expansion of healthcare as baby boomers age is a recipe for permanent productivity loss.
According to Executive Insight, any revenue process that impacts coding is predicted to experience workload increases. Providers are expected to struggle with code change ramifications for as long as a year. Three main areas for revenue cycle concern:
– “Heightened focus on medical necessity checking in patient access is required.”
– “Huge increases in claims suspensions within patient accounting departments are expected.”
– “More denials due to invalid codes and failed claims transactions are inevitable.”
Having all hands on deck to protect cash flow by producing clean, first-time claims will help soften the predicted and well-documented blow.
4. Manage your revenue cycle for financial impacts
Tied to allotting for proper training and staffing levels, not underestimating what will be financially required for both will help you get a healthy head start on ICD-10 transition. Furthermore, taking a closer look at your revenue cycle, from treating the patient to collecting reimbursement, will complement those efforts. Working with your CPA or practice manager to ensure you have the cash reserves in place to cover delayed payments, or at the very least, an accessible cash line from your bank, will be crucial. The reality being, that even with all the personnel preparations in place, things could get complicated from a technical perspective, according to HealthLeaders Media.
“Could things get glitchy? Absolutely,” said Jeannine Engel, MD, FACP and associate professor of medicine and physician advisor of billing compliant at University of Utah Healthcare. “I don’t think individual systems will be problematic, but things like electronic billing have the potential to have some bumps in the road…any time there is a changeover where there has to be communication, there’s a potential for problems.”
5. Don’t rely too heavily on contract-coding services
While it may be tempting to pass the buck on ICD-10 literally, it may not be the wisest long-term solution for transition, especially from a financial perspective. Prices of these services are expected to increase, especially as the deadline nears and provider anxiety and heavy contractor reliance grows. Furthermore, you will still need to monitor contractors’ productivity and accuracy, which will add to the overall costs of outsourcing.
Instead, consider hiring new graduates of outpatient coding positions and transition the current outpatient coders to impatient coder positions. Again, beefing up your coding team will provide a permanent solution to productivity concerns and cost less than long-term or permanent dependence on a coding company.
The resistance to make the changes internally, especially for smaller providers may lead to a permanent and costly reliance on outside coding. Cleaning up internal processes, which may also align with reimbursement models, may be a better place to put your investment dollars. Conducting internal audits of clinical documentation and implementing improvement programs is a good place to start, for example. According to Dr. Jeffrey Linzer, associate medical director of compliance for the hospital’s emergency pediatric group. ICD-10 transition is a major issue for physicians because most practices don’t employ coders. However, a better focus on internal practices could aid in the process. “If we could improve physician documentation, it would make the coder’s life much easier.”
Regardless of how organizations decide to tackle ICD-10 transition, the largest lesson from Canada may be this: Don’t resist the change that’s coming. Even if the House’s Safe Harbor Bill plan manages to produce yet another grace period for providers, it’s inevitable that time and options will eventually run out. So, don’t wait until the last minute to get on board with what’s coming. After all, you don’t have to look too far to know that too little can be too late—just look north.
