ICD-10 Implementation Deadline Affects Claims Processing
By - Healthcare payers have a wide variety of concerns with regard to the coming ICD-10 implementation deadline and will need to be prepared for any potential issues that may pop up after the October 1, 2015 deadline. With a mere six days left, those who have not prepared for the new ICD-10 codes will be left with various reimbursement claim issues and penalty checks from the federal government.
The Jacksonville Business Journal reported how the new transition to ICD-10 coding will transform many record-keeping practices throughout the healthcare industry including among insurance companies. The codes set by the World Health Organization (WHO) determine exactly how certain claims and billing aspects throughout healthcare are processed by payers and providers alike.
According to the Business Journal, the ICD-10 implementation deadline could lead to a loss in revenue among some players within the healthcare industry. The estimated costs of moving forward with the ICD-10 implementation deadline could be as little as approximately $56,000 to as much as $226,105 among small medical practices, the news source reported.
Among large medical practices, the costs related to the ICD-10 implementation deadline could skyrocket to more than $8 million. However, businesses in charge of software production and third party billing will likely see a rise in revenue due to the soon-to-be-here ICD-10 implementation deadline.
“If the codes are wrong or there’s lag time in their being submitted, from a cash flow standpoint, it’s going to cause some problems,” said Lisa Davis of the Jacksonville-based company Analytics Partners.
The new ICD-10 codes will be moving from 14,000 diagnosis codes to about 68,000. This is a huge transition and it will affect the outcome of claims management among healthcare insurance companies.
“No matter how prepared you think you are, it’s still dreaded,” Scott Quinn, chief financial officer for Southeast Orthopedic Specialists in Jacksonville, told the news source. “It’s like learning a new language, and the language is growing tenfold.”
“What really helps is communicating with every party involved in the revenue cycle,” Quinn continued. “Making sure the front desk, billing, third-party partners are all up to speed.”
As previously reported by HealthPayerIntelligence.com, there are a variety of concerns that healthcare payers have with regard to how the ICD-10 implementation deadline will affect claims management and processing.
For instance, the number of specificities will increase, which could potentially affect the number of claim denials in the future. Additionally, as more focus on healthcare payment is put forward, the new ICD-10 coding sets could make a potentially negative impact on the quality of patient care. Payers and providers will also need to keep track of any potential lapses in their ICD-10 preparations.
Since the ICD-10 implementation deadline is less than a week away, it will become more imperative for those within the healthcare industry to continually address any gaps or issues that come up once medical professionals and insurance specialists begin using the new coding system.
