Most training for ICD-10 should be well underway for coders and at a minimum, scheduled for physicians and other referring providers. But what about Revenue Cycle Staff? Patient Access (PA) and Patient Financial Services (PFS) activities will be impacted with the onset of ICD-10. PA and PFS staff do not need to know how to code; they need to have an understanding of code changes and how it impacts their work.
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:
- Authorization (current and prior)
- Clinical documentation
- Claims submission & reimbursement
- Reporting of quality measures
- Clinical workflow
- Financial workflow
- CBO workflow
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!