ICD-10 Financial Risk Assessment

//ICD-10 Financial Risk Assessment

ICD-10 Consulting Shift to Testing and Revenue Impacts

ICD-10 consulting will shift to testing and revenue cycle impacts in the next few months. Testing is the only way to ensure business continuity.

#ICD10 #NoDelay Trending on Twitter Today, Testing is Issue Not the Delay

ICD-10, the International Classification of Diseases version 10 from the World Health Organization (WHO) is supposed to go into effect in the United States on October 1, 2014 2015.  Today on Twitter, proponents of ICD-10 asked the U.S. Senate not to delay ICD-10 as part of H.R. 4302.  H.R. 4301 is designed primarily to re-adjust  the [...]

ICD-10 Benefits Pharmaceutical and Medical Device Companies

ICD-10 (International Classification of Diseases version 10 developed by the World Health Organization or WHO) code set has the potential to bring new analytical capability to pharmaceutical and medical device companies eager to improve efficiency and to differentiate themselves in the new regulatory economy. Today’s pharmaceutical and medical device company analytic capabilities are not sufficient [...]

ICD-10 Impacts Case Management and Case Management Reporting

When thinking about ICD-10 program governance, one of the key areas for both traditional Fee for Service (FFS) medicine and the transition to episodic (short-term) and longitudinal data for comparative effectiveness medicine in the Affordable Care Act is the Case Management process and supporting software and reports.

ICD-10 Financial Impact Assessment

ICD-10 Financial Impact Assessments should include an understanding of: ICD-10 Financial Impact to Revenue Cycle Management ICD-10 Financial Impact based on DRG shifts ICD-10 Financial Impact based on ICD-9 to ICD-10 mapping risk ICD-10 Financial Impact based on use of unspecified codes Health Information Technology (HIT) Impacts: ICD-10 Financial Impact to the Health Information Management (HIM) department ICD-10 Financial Impact to IT as distinct from the clinical applications such as resource conflicts ICD-10 Financial Impacts to training budgets, which should include the Human Resources Department ICD-10 Financial Risk and Impacts to denial management with respect to payer relations and contracting

Assessing ICD-10 Financial Risk by Service Line

ICD-10 transition and risk assessment best practice by service line: Physician engagement, combined with chart audits and analytics must be used carefully in a balanced method to ensure that the ICD-10 transition works smoothly across service lines, physician groups, and financial management.

ICD-10 Financial Risk Assessment Should Include Data Quality Assessment

ICD-10 Financial Risk Assessments should include an analysis of historical healthcare claims data for one, two, or ideally three retrospective periods. A data quality assessment is essential, making sure that claims are not duplicates, and that they therefore represent unique events. This is particularly important in view of interim billing on hospital claims. It’s very easy to count hospital admissions multiple times from claims data unless you reconcile claims to a single hospital stay.

ICD-10 diagnosis and ICD-10 procedure codes impact provider patient scheduling workflow

ICD-10 will impact scheduling workflow. If your current systems capture ICD-9 codes, your IT team will need to remediate and test scheduling systems. Ultimately, an ICD-10 Financial Risk Assessment, ICD-10 testing, and ICD-10 implementation plan should comprehend ICD-10 provider scheduling.

ICD-10 – People, Process & Technology

The significant increase in code classifications will affect how departments function within themselves, with each other and with outside organizations. As payers take the time to become educated about ICD-10 and 5010, it becomes clear that the impacts are not contained within one area of the business, such as claims.

10 Steps to a Successful ICD-10 Assessment and ICD-10 Transition

ICD-10 Assessments should lead to actionable approaches using an ICD-10 Financial Risk Assessment, ICD-10 Business roadmap, ICD-10 training for coders, ICD-10 training for physicians, ICD-10 specialty training, ICD-10 vendor readiness, ICD-10 test plan, ICD-10 test data, and an ICD-10 pre-go-live ICD-10 risk assessment. More and more health care companies are realizing that as the deadlines [...]