ICD-10: Prepare Your Revenue Cycle Now, Part 1

shutterstock_229212595Given the delays we’ve experienced to this point, many providers may be skeptical about the 2015 ICD-10 deadline, or perhaps whether or not it’s ever really coming. But does anyone really think that, with all the investment our government has made in ICD-10, it’s not really coming? Of course it is; whether it’s delayed again or not, it’s on its way and the ramifications for those practices that are unprepared are going to be potentially devastating.

Imagine that day when ICD-10 is finally in place, and you haven’t made the transition from ICD-9. What are you going to do when Medicare refuses payments due to noncompliance? What are you going to tell your employees when you can’t make payroll and you’re shutting the doors, because your revenue cycle has crumbled under the weight of Medicare non-reimbursements?

Sound far-fetched? If it does, perhaps you haven’t been paying close enough attention. Here’s the reality: while Medicare payments won’t stop cold on the deadline day, claims for dates of service after the deadline will not be paid.

Even under the best circumstances, there are going to be delays as everyone struggles to get on the same page with the new codes. The good news is that, thanks to the most recent delay, you still have time to make the transition and prepare your revenue cycle.

Okay, there’s more good news. In this three-part blog series, we’re offering another look at our Six Steps You Must Take Right Now to Prepare Your Revenue Cycle for ICD-10. Here, for your consideration, are the first two.

Come to terms with the reality of increased denials
Move quickly to develop your plan for dealing with it. With the increased complexity of ICD-10 codes and no simple mapping or translation between ICD-9 and ICD-10, your coders are going to have a pretty steep learning curve and, as a result, diminished productivity. Not only that, but your payers are going to make mistakes, too, which is going to slow your reimbursements even more.

To reduce the impact of these slowdowns, make sure that your billing department carefully evaluates your current procedures as soon as possible and considers any necessary changes to internal processes, systems and workflows.

If you haven’t done it yet, develop a sound strategy to streamline your revenue cycle management processes and protect your cash. Without question, this is the first step you should take.

Increase your cash reserves
An important component of that plan should be to bolster your cash as soon as possible by accelerating and/or liquidating as much of your outstanding receivables as you can. You’ll improve your financial health and be in better shape to face the slowdowns.

Enhancing your self pay collections is a huge part of building up cash reserves. With more and more patients now responsible for significant portions of their own healthcare costs, it’s imperative that you take aggressive steps now to tighten up your patient collections efforts and make sure you don’t leave any money on the table.

Remember that successful self pay collections begin with effective communications and continue with dialogue throughout the process, especially after the invoice is sent. Your friendly, caring conversations underscore the patient’s positive experience with your organization and must be viewed as part of your overarching patient care model. As we’re fond of saying, “patient care doesn’t end at the exit door.” And when patients are informed and educated about their bills, they’re much more likely to pay them.

While the ICD-10 deadline now won’t come until October of next year, that’s still not a lot of time to get ready—especially if, like many providers cited in a recent survey, you haven’t made much progress yet. So if you haven’t already, please take our proven revenue cycle steps to heart and get the ball rolling.
We’ll be back shortly with two more revenue-cycle-protecting tips. In the meantime, we’d like to offer you another great resource.

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About Cynthia Sherman, Director, Coding Services

Cynthia Sherman, Director, Coding Services

Cynthia leads all aspects of Coding Services at MediRevv, including the day to day management of coding operations and client account management. As Director of Coding she has grown division from a staff of one to forty. She is certified CCS-P (2002) through AHIMA.

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