Your Webinar will begin shortly...
Should a Practice Outsource Billing to Prepare for
ICD-10 Challenge? We will be tweeting live @Ken_Edwards01
#CureMDWebinar
Presenter
Ken Edwards Senior Billing Manager, CureMD
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
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
ICD-10 changes EVERYTHING
. .
The change that will shake the healthcare industry Claim errors will increase by 7%
Revenue and cashflow impact of ICD-10
.. ..
40% increase in A/R days (CMS) 200% rise in claim denial rates (CMS) Justify the medical treatment Complex denial appeals
Source: Centers for Medicare and Medicaid Services
Scenario 1 Vendor Readiness
What should you ask your current vendor?
Will your products be ready for the ICD-10 compliance date?
ICD-10 Readiness
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?
Cost
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 ?
Implementation
Will you help me test my ICD-10 compliant EHR and practice management system with my payers? 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?
If your EHR Vendor does not respond in a timely manner
or
if the responses you receive are vague
Consider Switching
Scenario 2 Practice Readiness
Are you up for the challenge?
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)
It is estimated that physician productivity will decrease by
10%-20% due to ICD-10 documentation
ICD-10 will infiltrate your domain
Physicians
Clinical Area Managers
Nurses
Lab
Front Desk Billing
Coding
Source: American Academy of Professional Coders
Is your Billing department up for the challenge?
1..
Benchmarking important KPIs
..
Where do your denials stand? Denials > 4% = poor performance Cost per denial = $30 Adm
Pati
ent
care
inis
trat
ive t
ime
2.
Started training coders? 16 hours on ICD-10-CM
24 hours on ICD-10-PCS 10 hours on practice implementations (AHIMA)
Source: American Health Information Management Association
3. .
Hiring in-house billers? Professional coder costs $50,000
4. .
A/R management?
. .
Exceed 120 days Periodic reports Specialty-level comparison
5.
Resources for PQRS and MU Stage 2?
Is your practice on track ? 2014
2015
Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep
D E A D L I N E
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
O C T
TESTING High-level training for test team Level 1: internal Level 2: external COMPREHENSIVE TRAINING Documentation Coding
Oct
1
Ongoing practice before “go live” Ongoing practice before “go live”
2 0 1 5
Nov
Dec
If your practice is not prepared for ICD-10 Consider Outsourcing!
In-house vs outsourced In-house
Cons
Retain Control Close Proximity
Liabilities Sta issues Higher costs
Outsourced
Pros
Less Expensive Transparent Enhanced Consistency
Hands o Hidden Fees
Fact 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. Source: Black Book Rankings Survey 2014
Choose the right billing vendor
. . . .
Do not select a billing company solely on low rates without considering the risk attached to it 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.
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
CureMD Value Proposition
Billing Service ICD-10 consultation team 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.
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.
QA &
Session
Need Help? 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
Thank you
Look out for our email, containing the webinar recording and free ICD-10 ebook