It might sound like an impossible office manager’s dream, but it is possible to improve office production while also training for and implementing ICD-10 changes. Many practices are choosing to hire a healthcare consulting firm to assist with areas of billing and coding management that might need support, training and improvement, such as Medicare reimbursement and collections. With so many things already a priority and so many changes happening in the healthcare field, there are some pretty valid concerns about what problems might crop up when the ICD-10 changes are implemented in October. The new requirements are so specific and there are so many new codes to learn, that many are concerned it will take even more time than it already does to make sure everything is done correctly.
Recommendations for ICD-10 from the AHIMA
According to American Health Information Management Association, there are three things that your ENT practice needs to be doing right now, if you haven’t done them already, to prepare for the ICD-10 changes. Many of these suggestions would benefit from the professional assistance that comes from a healthcare consulting firm, such as MD Pro Solutions, who specializes in billing and coding management for Ear Nose and Throat practices and other otolaryngology clinics.
STEP ONE – Training
The first thing that you and your staff will need to ensure that you are properly prepared for the coming changes to ensure timely Medicare reimbursement and avoid costly coding errors is to receive professional training. Healthcare offices should be providing training and support for their billing staff in advance of, during and after the ICD-10 changes are implemented to ensure that they have the tools they need to get the job done right. Once training has been completed, many offices have started doing dual-coding, putting the ICD-10 codes into practice ahead of the change, to ensure that they know how to do them in a real life billing and coding management situation.
STEP TWO – Increase Staff
Another way to make sure that your billing department doesn’t come to a screeching halt and the flow of income into your practice slows down to a dangerous pace is to consider hiring more staff or at least hiring temporary staff during the transition period. Hiring staff that has already received training for the ICD-10 changes, who can keep you on track with Medicare reimbursement, will be a huge benefit. Not only will they be able to just jump in and take care of billing and coding management in your ENT practice, but they will be able to provide in-house support to your current staff to ensure that they are confident with the new codes and procedures. Also, consider outsourcing billing and coding services while your staff is training if you waited too close to the deadline to get started.
STEP THREE – Boost Resources
One of the advantages of working in medical billing today are all of the resources available that can help you to get ahead. Working with a healthcare consulting firm like MD Pro Solutions can give you options, such as working with computer or online assisted coding and support, clinical improvement tips and techniques, apps that can help coders transition to ICD-10 changes, training and testing programs, and much more. Using all of these resources at your disposal can not only help you prepare for the coming changes, but it can help to make your office more productive and efficient overall.
“Grace Period” of Sorts for ICD-10 Changes
In July, the Centers for Medicare & Medicaid Services (CMS) announced that they would be working with the American Medical Association (AMA) on options that could help concerned medical practices ease into the ICD-10 changes more effectively. To ensure Medicaid and Medicare reimbursement, they have stated that “Medicare review contractors will not deny physician or other practitioner claims billed under the Part B physician fee schedule” for 12 months following the ICD-10 implementation for reasons that are “based solely on the specificity of the ICD-10 diagnosis code as long as the physician/practitioner used a valid code from the right family.” However, it is still strongly recommended that ENT practices get some type of billing and coding management help, training and support during this time.
Additional allowances were also made with regard to quality reporting and other penalties, such as not subjecting Eligible Professionals to penalties if “CMS experiences difficulty calculating the quality scores for PQRS, VBM or MU due to the transition to ICD-10 codes.” Advance payments may also be issued to physicians, according to the President of the AMA, if Medicare contractors are unable to process their claims due to problems with ICD-10 changes” to prevent payment disruptions.
The CMS has also announced an intention to create a communication center, which would include an ICD-10 ombudsman that would help to assist with issues faced by physicians and providers. The goal is to “identify and initiate” resolutions for those issues that are caused as a direct result of the new coding sets. All of these provisions were brought about due to direct calls from the AMA, members of the U.S. Congress and other entities. Congress initially requested a dual-coding option for the first year that would allow for claims to be submitted with both ICD-9 and ICD-10 coding, as practices became more familiar with the new changes. However, CMS has stood firm in the requirement of all claims being submitted with valid ICD-10 coding beginning on October 1, 2015.
Billing and Coding Management Support
For help with ICD-10 changes, Medicare reimbursement, online training, medical office consultations, outsourced billing and coding, as well as other related services, consider hiring a healthcare consulting firm like MD Pro Solutions. Give us a call at 508-946-1665 to find out more about the services we provide or to set up an appointment for an evaluation.