Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Policy & Regulation News

Cerner: ICD-10 Collaboration Efforts, Support Systems Vital

By Jacqueline DiChiara

- ICD-10 implementation – the tenth edition of the International Classification of Diseases – launches today, October 1, 2015, with the healthcare industry now mandated to embrace an in-with-the-new coding and documentation mentality. ICD-10 may mean massive financial chaos across the healthcare industry if physicians and hospitals use outdated codes and subsequently erroneously bill patients.

icd-10 codes denials

Several healthcare experts have confirmed to earlier this week that ICD-10’s launch brings about massive payment delay anxiety for physicians as the extent of the reimbursement impact becomes more tangibly understood in coming weeks. The most instantaneous gauge of ICD-10 success may be financial as the possibility of patients’ bills being inaccurate becomes reality as healthcare providers consider how to maintain a smoothly executed billing cycle.

Continuing this discussion onwards, recently spoke with Mike Hourigan, Director of Regulatory & Compliance at Cerner Corporation, about today’s ICD-10 implementation launch and where the healthcare industry should now be focused as the claims management and denials aftermath is examined and analyzed.

Says Hourigan, everything begins with the physician and the specificity needed within documentation. “Clinical staffs will have to adjust to the change. That’s why it’s been so important to have a comprehensive training plan in place for physicians, clinical documentation improvements, specialists, coders, and clinical staff that actually deal with documentation,” he maintains. “Everything really starts with the physician and the specificity you need within the documentation. It will have a negative impact if the documentation isn't correct.”

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  • Hourigan says multiple ICD-10 testing efforts have helped bridge the gap between expectation and reality. It will be vital for health systems to now pay close attention to the monitoring of key performance indicators, he says. From a revenue cycle angle, consider concentration efforts on Discharged, Not Final Billed (DNFB) accounts, receivable days, and denials, he advices. Additionally, be sure to execute similar monitoring efforts on the clinical side, explains Hourigan.

    “Within the Cerner Millennium Platform, we have the ability to have timers in place to monitor key processes within the clinical work flow, like documentation times for physicians and how long it takes them to locate diagnosis within the system and other clinical processes,” he confirms. “There’s a potential for slowdown in multiple places so we need to keep an eye on it going forward,”

    There is a wide variety of ICD-10 implementation readiness levels across the board, says Hourigan. “You’ll have health systems tell you they were ready last year at this time. Then others were a little slower to pick it back up again after the delay was announced. All in all, our clients are telling us they’re prepared,” says Hourigan. “There are unknowns since we’ve never gone through this before as an industry. We are planning for the worst and hoping for the best.”

    Hourigan says a strong focus needs to be placed on implementing a solid support strategy during the ICD-10 cutover. “Cerner is standing up a command center to support the transition. We’ve had a lot of providers say that they’re going to do the same thing and have a command center or a hotline people can go to when they have questions,” Hourigan explains.

    “The other important piece of this is making sure everyone has been communicated to properly and knows what to expect during the transition. A lot of this goes back to if they were trained properly and if training was enforced in the days and months leading up to the transition,” he says. “We have to be collaborative in this effort going forward. It won’t be a Y2K where it’s over quickly. It’s going to be an extended process and everybody has to work together to get there.”

    As the ICD-10 implementation dust settles in upcoming weeks and months, it is hopeful revenue cycle management will remain in tact and healthcare professionals and providers will be aptly able to handle claims denial bumps along the way.


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