The deadline is fast approaching. On October 1, 2015 the long-awaited diagnosis codes will take effect, requiring all healthcare providers to comply or risk issues with reimbursement. ENT billing and coding, like all other medical specialties, will also be affected by the ICD-10 deadline and changes. While the changes are designed to eventually simplify the billing process for fast and accurate credentialing by using more specific coding, the changes in the latest update are large enough to have caused significant slowdowns in billing and payment processing in other countries around the world. The United States delayed implementation after concerns were expressed by the medical community, but the date has now been set and otolaryngology billing and coding will never be the same.
The Transition: Phasing Out ICD-9 Prior to the ICD-10 Deadline
Healthcare providers at individual practices, clinics and hospitals are facing an increase in the total number of billing codes, from about 17,000 to 140,000. Administrators who deal with ENT billing coding will need to have a much more in-depth knowledge of medical terminology, as well as physiology and anatomy, in order to properly provide fast and accurate credentialing. In order to properly conduct otolaryngology billing and coding after the ICD-10 deadline, coders will have to work with doctors more closely to be able to accurately use the proper coding methods.
One of the biggest changes is that superbills, which have been used to help code services and diagnoses quickly for proper billing, may no longer be helpful. In fact, many experts believe that the additional codes that are being added will make superbills obsolete, forcing doctors and clinics to purchase brand new software that will be able to accept the longer codes after the ICD-10 deadline. Changes will also happen with regard to patient coverage, as doctors will need to be much more specific in the documentation and code observations that they provide, including the various stages of healing from affected illnesses or injuries.
What this will do is increase the workload for everyone – not just ENT billing and coding. The doctors will spend more time in documentation for each patient and the case managers will be spending more time on the phone to explain coverage charges to patients. As a result of all the new coding and time being spent at the office, medical providers could also see a slow down in the accounts receivable. This decrease in cash flow could be serious for some providers who are already strapped for cash. More codes means more chance for mistake, which could potentially mean an increase in calls due to rejected or confusing claims, which could result in more audits for each otolaryngology billing and coding department.
We Can Help: How to Get Your Practice or Clinic Prepared
If all of this sounds like a huge nightmare about to happen and you are not sure whether your ENT billing and coding department is ready to handle these changes, there is hope. Many practices are hiring an outside medical consultant to come into their office and find out if they are ready to make the transition by the ICD-10 deadline. There are a couple of things that a consultant, such as MD Pro Solutions, can do to help.
- start with an analysis of your current ENT billing and coding system to ensure that everything is being done effectively, efficiently and according to requirements
- provide your billing team with the authorization training, testing and screening needed to improve knowledge and education of medical billing and coding
- provide education and training of the changes required in the ICD-10 deadline
- educate your staff on patient financial policies, develop policy manuals
- provide support online for CPT with RVU global days and CCI edits
- provide support online for ICD-9 and ICD-10 cross-links and related issues
- work with your staff to ensure fast and accurate credentialing
In addition to our educational training programs, we can also help provide you with account management services that will support your otolaryngology billing and coding department by conducting a complete analysis and update of all your medical billing codes and software. Help by reviewing all of your forms, billing programs and medical systems to ensure that they are up-to-date and will be able to assist you in the transition prior to the ICD-10 deadline. We can even help you to increase receipts, give you the tools that you need to prevent fraud related issue by conducting offside audits by a CPA and by scheduling account reviews for continued account management assessments.
Another Option: Outsourcing ENT Billing and Coding
If you no longer want to deal with the headache of ENT billing and coding, or simply do not have the staff or the man hours required to keep up with all of the changes coming with the ICD-10 deadline, there is another option. Many practices and clinics are turning over their otolaryngology billing and coding to a professional outsourced solution. MD Pro Solutions can help you in this area. Our staff are fully trained, certified and experienced in the medical specialty area of Ear, Nose and Throat billing and coding. We can take it all off your hands and will apply some of the most aggressive and effective billing practices to your accounts to increase revenue and ensure that you are accurately billing your patients.
To find out more about outsourcing, training, education, support and other services provided by MD Pro Solutions, give us a call at 508-946-1665. Our team can help you to make the improvements needed to get you back on track, prepare you for the future and improve your cash flow, leaving you with more time to work with your patients and provide them with the care and support they require.