Revenue Cycle Management for ICD-10

1

Rich FlahertyVP of SalesMDeverywhere

Revenue Cycle Management for ICD-10

2

Agenda

• Why ICD-10

• Practice implications

• Partner for success

• Asking the right questions

• Key takeaways

33

WHY ICD-10?

44

55

Pros and Cons of ICD-10 Delay

ICD-10 Delay Creates Headaches

Senate Passes One-Year SGR Patch, ICD-10 Delay Bill

ICD-10 Delay: Politics Versus Policy

66

77

Much Has Changed Since 1979

88

9

ICD-10 Is Necessary

• Greater specificity, improved tracking

• Longer codes, larger code set

• Improved monitoring of global health trends

ICD-9 ICD-10

Pressure Ulcers 9 codes 150 codes

Angioplasty 1 code 854 code

1010

IMPLICATIONS FOR YOUR PRACTICE

11

Implications

• All aspects of patient encounter will change

• Disruption in operations and payment streams

• Loss of productivity

• Software breaks

• Staff turnover

1212

Sobering Facts

5xHFMA prediction on increase in denials.

$50-200KEstimated spend on

transitions costs.

80%Practices will need

to upgrade software.

6 MonthsRecommended

amount of cash flow in-house.

1313

SURVIVING THE TRANSITION

14

Minimizing Impact

• Don’t underestimate the degree of change

• Invest in training

• Assess documentation procedures

• Engage staff early

15

Consider an RCM Partner

• Choose and RCM partner invested in ICD-10

• Leverage resources and capabilities

• Leverage operational scale, technical expertise

1616

FINDING THE RIGHT PARTNER

17

When Will Your System be Compliant?

1/3 ICD-10 Ready Now 2/3

Not Ready

27%Would not have been ready by Oct. 1, 2014

deadline.

18

Are There Additional Costs?

19

Customer Support & Training

20

GEMs & Crosswalk

• Supplement with extended search capabilities

• Natural language parsing

• Code set selection based on payor readiness25%ICD-9 codes

have an exact match to ICD-10

21

Dual Coding

• Support simultaneous use of codes for training

• Benchmark productivity for live implementation

• Testing with outside organizations

22

External Testing Strategy

National Testing Week March 3-7, 2014

Claims tested successfully with 100% accuracy and

without rejections.

23

Key Takeaways

• ICD-10 is inevitable and necessary

• Keep the pedal to the metal

• Don’t stop your ICD-10 preparations

• Partner for success

• Ask the right questions

24

About MDeverywhere

• Leader in Revenue Cycle Management

• MicroMD Strategic Partner

• Serving 7,000 physicians, 40+ specialties

• MDe clients increase collections 10-15%

• Decrease denials by 95%

• NCQA CVO certified

2525

Thank You

www.mdeverywhere.comquestions@mdeverywhere.com

631.232.4260, option 4