ICD-10 implementation need not delay reimbursements

It's not hard to understand why many physicians are asking for a two-year delay of ICD-10 implementation.

We keep telling physicians that they may have to survive without reimbursement revenue for six months after Oct. 1, 2015. Why would anyone want to go through that?

But it doesn't have to go down that way. There are some steps that medical practices can take to mitigate the risk of reimbursement delays.

Stockpile cash reserves now

Some experts suggest that medical practices should save enough money to keep running for six months. I'm not sure if that is feasible for many small practices. Not many physicians may see this as an option.

Reduce accounts receivable

Lower your accounts receivable (AR) as much as possible now. Shoot for less than 30 days. ICD-10 implementation could increase the AR cycle.

Spend money to make money

It may be worthwhile to hire more medical coding or billing staff who will code claims correctly. Outsourcing these functions could be an option too.

This investment in expertise will reduce the chance of rejection and/or denials, and it's going to help to get medical claims out the door as soon as possible.

Improve clinical documentation

This is going to help ICD-9 coding now (which can improve reimbursements and make it easier to stockpile cash or invest in training) and prepare for ICD-10 coding in October 2015. Medical coders will have more information, so they can process medical claims more quickly. And it will help justify diagnoses if healthcare payers question medical claims.

Thoroughly train all staff

Better training will lead to properly coded medical claims that healthcare payers will be less likely to reject.

Also, early training will allow medical practices to start dual coding. By taking time to code existing medical claims with ICD-10 codes, medical practices can:

• Reinforce ICD-10 training in medical coders.
• Soften the expected blow to productivity.
• Find the gaps in clinical documentation.
• Develop some sense of how DRGs may shift after Oct. 1, 2015.
• Create comparable data that will be useful after ICD-10 implementation.
• Get really good at ICD-10 coding.

Open lines of communication with healthcare payers

Early communication will help healthcare providers test the ICD-10 claims process and gain insight into how reimbursements will be affected after Oct. 1, 2015. The latter will help prepare for DRG shifts. This puts a price tag on procrastination.

Communication will also help develop relationships with healthcare payers. This could speed responses when providers need answers and clarification during the claims process.

Test early, test often

It's better to find out what's going wrong before Oct. 1, 2015 than after. At that point, problems will mean reimbursement delays, denials or rejections.

It will also open up lines of communication with your payers.

Consider clearinghouses

Clearinghouses have the benefit of seeing all kinds of problems with medical claims. They might be able to help medical practices avoid problems that other practices experience. And they should have good relations with healthcare payers. Their phone calls probably will be returned sooner.

Going without reimbursement revenue need not be a given. The better prepared healthcare providers will be able to keep revenue cycles optimized.