GeBBS Healthcare Blog

Administration of vaccines is an important part of healthcare delivery, and a critical contribution to preventive public healthcare. However, risings costs are making it difficult to align vaccine administration expenses with revenues.

There may be some relief to these rising costs and it comes from something that was once seen as a burden for medical practices. That relief comes in the form of ICD-10 coding.

The world did not come to an end on October 1, 2015. With the start of ICD-10, healthcare professionals anticipated an overall reduction in productivity of their billing staff. In a pre-October 1 survey, 94% of respondents indicated that they expected increased denials, but only 30% had done any work toward solving the problem. 

If you are one of these, you are suggested to begin immediately to improve your denial management processes and your ICD-10 coding. Most providers, payers, and even CMS expect there will be a noticeable increase in the coding denial ratios, which currently range between 15-20%, and may actually double. Though, by design, ICD-10 is expected to reduce the denial rates; in the short term there is bound to be reduced collections, higher denial ratios, and lower productivity.

October 1st is almost here.  Here is a quick checklist to ensure you are ready:

1. Have you identified the top ICD-9 diagnoses and trained appropriate staff on the corresponding ICD-10 coding for billing and clinical documentation?
2. Have you reviewed current clinical documentation and identified gaps for ICD-10 requirements?
3. Have you contacted all your vendors to ensure they are ICD-10 compliant, such as payers, clearinghouses, and any outside vendors?
4. Have you tested submitting codes to your payers and clearinghouses?

If you are getting a late start on ICD-10 preparation, don’t worry; there are still cost-effective and viable solutions that can help you meet the October 1 deadline – outsourcing and technology.

The transition to ICD-10 will have a tremendous impact on your organization and its revenue stream. If you are getting a late start on ICD-10, you may want to consider using an outside partner, who has been diligently preparing for the ICD-10 transition for several years. An outsourcing partner can provide immediate expertise to ensure your revenue risk is minimized. 

October 1 is just around the corner. There is no other way to express it. Are you ready?  Training to ensure you are ready for ICD-10 is the most critical factor in preparation. You should determine your staff’s training needs based on their individual roles within your organization. Staff members will require different and specific education based on their role in the ICD-10 coding process.

First and foremost, select an experienced training partner such as GeBBS!

By Nitin Thakor, President & CEO

I read with interest this week an article In Modern Healthcare’s e-newsletter titled, “Uninsured rate dips below 10%.” The statistic comes from The Centers for Disease Control and Prevention.

In my opinion the most important sentence in the article follows: “The survey also found that 36% of people younger than 65 were enrolled in a high-deductible health plan in the beginning of 2015.”

The growing number of people – not only the young -- who are opting into these high deductible plans is forcing healthcare financial managers to re-evaluate their present revenue cycle management solutions, and look to the next generation of solutions for answers to their financial woes. Shifting payment models, new regulations and healthcare reform are forcing healthcare leaders to redirect previously launched budgets, priorities and strategic plans to assess if new solutions can rescue them from imminent financial catastrophes.

Dual ICD-9/ICD-10 coding can generate benefits that far outweigh the negatives, if it can be done without creating productivity declines and revenue cycle slowdowns.

There is a huge cost factor to dual coding if you have to do it manually; however, there is a way to dual code without involving every coder on your staff in the process. Technology is available today in the form of computer-assisted coding (CAC) tools.  CAC is a proven technology that automatically derives and assigns ICD-10 medical codes from within your clinical documentation with a 95% accuracy rate. For GeBBS, its proprietary algorithm built in its iCode coding platform leverages deep data learning principles of both ICD-9 and ICD -10 codes.

With this kind of technology, your organization can dual code in ICD-10, while still maintaining your present ICD-9 workload.  These CAC technology solutions can work with your electronic health record (EHR) and financial systems to produce extremely accurate coding.