Under ICD-10, it is anticipated that denials will increase 100% – 200% from the current denial amount. Cash is projected to decrease. Accounts Receivable is slated to increase. CFOs will look to PFS to maintain financial results, so a gap analysis of current to future state is needed now for ICD-10.

From front to back – Scheduling to Denials Management – robust testing must be done to implement the new coding methodology. There are many entry points that involve diagnosis and procedure coding under ICD-9. Each of these areas will be impacted by the ICD-10 change. Vendors are aware of ICD-10 but must be monitored within the Revenue Cycle to ensure compliance with the October 1, 2014 implementation date. System interfaces to current PA and PFS systems must also be tested. The changes in systems only work if they interface properly.

Revenue Cycle ICD-10 points of impact typically include:

• Scheduling
• Registration
• Eligibility
• Authorization (current and prior)
• Clinical documentation
• Claims submission & reimbursement
• Reporting of quality measures
• Clinical workflow
• Financial workflow
• CBO workflow
• Denials

If you have Revenue Cycle operational, analytical, or educational needs, we can help you make the crucial shift to ICD-10. KHC has a balanced team of revenue cycle, compliance, accounting, clinical, and coding professionals. We can customize your ICD-10 education to address your priorities. Call Kohler Healthcare Consulting Today!

“Ready or not here I come!” But ICD-10 is no child’s game.

ICD-10 is a game changer.

Looking at shift in the sheer volume of codes is indicative of the magnitude of change required. We are moving from 18,000+ codes under ICD-9-CM to 141,000+ codes under ICD-10.

Many providers are well underway with their coder education initiatives. If you need additional resources we can help you with that, but coder education is the proverbial “tip of the iceberg.”

Physician clinical documentation is critical. If you are not seeing consistently excellent clinical documentation now, there is high risk of substantial denials post ICD-10. Operational processes are also impacted. Many Policies and Procedures will require updating. A critical review of billing compliance readiness is prudent. Revenue is impacted. It is important to know where and by how much. For example, changes in reserves may be needed.

If you have operational, analytical, or educational needs, we can help you make the crucial shift to ICD-10.

Why KHC?

• We employ a denial prevention mindset to solve the right problems.
• Your claims data is put through a data mining process to provide comprehensive, yet inexpensive, risk assessment.
• Our approach provides a “speed to value” look at your DRG “winners” and “losers.” In addition, it provides a variety of data “slices”- i.e., departmental as well as service line.
• We are experts in providing the critical physician education needed to bring clinical documentation to meet the exacting specificity needed for coding and billing under ICD-10.
• We deliver custom ICD-10 education focused on your priorities. We use your medical record and claims data to make training relevant and effective.
• Our expertise includes hospitals, sub-acute and post-acute entities, as well as physician practices.