The Best Medical Billing Companies Can Help You Navigate the New Frontier of ICD-10.
The Best Medical Billing Companies Know ICD-10
October 1, 2015 is D-Day for implementation of ICD-10 and that is the day you need the best medical billing company on your side to help you navigate the new frontier. That’s the day when coding expands exponentially. The forecast isn’t pretty.
The Centers for Medicare & Medicaid Services (CMS) estimates that in the early stages of implementation:
- Denial rates will rise by 100 to 200 percent
- Days in A/R will grow by 20 to 40 percent
- Claims error rates will be more than two times higher with ICD-10, reaching a high of 6 to 10 percent (compare to an average 3-percent error rate with ICD-9)*
- A typical turnaround time for claims processing of 45 to 55 days could end up being extended another 10 to 20 days
- AHIMA reports that on average coders took nearly 18 minutes longer to code a record in ICD-10-CM/PCS than they did in ICD-9-CM.
The American Health Information Management Association (AHIMA) says the shift to ICD-10 will change the nature of denials and their management. Claims denials will not strictly be a matter of clarification that can be handled by a nonclinical person in the billing office. This means that a certified billing and coding specialist may no longer be optional if you are going to have the most effective medical billing programs. The best medical billing companies are well educated in ICD-10 and stand ready to come into your practice and bring you up to speed.
The depth and types of documentation required before even processing patient claims is going to expand, and physicians will have to be ready to add clinical perspective and input when denials occur.
According to AHIMA, “Denials will raise questions about medical necessity or the clarity of medical documentation supporting a code; such questions will require input from a physician, nurse specialists, or outside expertise.” Physicians are going to be required to become more involved in denials management.
This isn’t the time for the meek.
This is the time to bring in one of the best medical billing companies you can find; experts in healthcare revenue cycle management who can streamline your revenue cycle workflow for optimal profitability and efficiency. This should be done with a multi-pronged approach that combines clean claim submission, denials management, contract compliance, and coding and online medical billing improvements and the strategic use of technology.
MICI will implement proven processes that will increase the efficiency and profitability of your medical practice.
It’s a complicated world out there. We can make it simpler for you.
*CMS nationwide testing of the ICD-10 system, conducted this past January, showed that they were able to accept 81% of the 14,929 test claims, with 6% rejected because of invalid submission of ICD-10 diagnosis or procedure code and 13% because of non-ICD-10 related errors, including issues setting up the test claims (e.g., incorrect NPI, Health Insurance Claim Number, Submitter ID, dates of service outside the range valid for testing, invalid HCPCS codes, invalid place of service).