As we scurry to keep up with the rest of the developed world who are already utilizing ICD – 10, we face unprecedented system change, and a true threat to cash flow in the months following this transition. With the false starts in 2014, many healthcare professionals are wondering if the October 1 deadline for this year will stand, or if it will be postponed yet again.
Regardless, we will have to begin
utilizing ICD – 10 coding at some point in the very near future, so a high degree of preparedness is in order. What does this mean for clinic administrators and Centricity super users?
As always, we can divide a major change like this one into its component parts:
2. Workflows and training
3. Financial considerations
With regard to systems, there are multiple changes that are now supported within the Centricity v. 12 software. It is expected that the automated cross walking feature will translate ICD-9 codes to the appropriate ICD–10 code in approximately 70% of instances. For super subspecialties however, this percentage is much lower and will need to be addressed with workflows and training. We are fortunate to have the ability to turn on ICD-10 billing by payor within the Centricity product. This will allow the system administrators and business office managers some granularity not afforded by other pieces of software. Our strong recommendation will be for groups to utilize the internal tools, and to begin processing claims with any payor that is ready as soon as the clinic is ready. This will smooth the implementation, and reduce the potential financial impact.
This workflow change is one of the more pervasive that we have seen in a while, so our suggestion is to spend an appropriate amount of time training the providers and their support staff on the internal tools for Centricity, including the crosswalk. It is also critical to let providers know what their work will be, so that they may plan how best to accomplish that given their personal practice styles.
While the financial impact of ICD – 10 is as yet unknown, we can predict that it will take significantly more time to code a diagnosis, and that this kind of transition presents an opportunity for insurance payments to be slowed significantly. We are hearing industry recommendations that clinics have a line of credit secured to cover six months of operating expenses in a worst-case scenario going into this transition. While we are all hopeful that there will not be that kind of delay with claims, it is possible–and highly probable–that clinics will see a reduction in their cash flow in the last quarter of this year.
ICD–10 may well be a necessary evil, but it is an operational reality for all of us. The successful clinic administrator will plan for implementation very carefully and thoughtfully.
As we would like to be in support of this, we have set the agenda for our April Centricity User Group meeting to be focused on ICD–10. Join us for a review of the software, workflows, and operational supports necessary to make this a smooth and successful transition for your clinic.
By Jill Arena- Partner Health e Practices