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ICD-10 Claims Monitoring Infographic

Posted on June 30, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m told that there are only 92 days left for Congress to delay ICD-10 until the deadline to implement ICD-10. A few weeks ago we published a great post from Vishal Gandhi, CEO of ClinicSpectrum, that talked about a part of ICD-10 preparation that is often forgotten: Claims Monitoring.

I know this is going to be a major problem for many healthcare organizations and is going to cause some major cash flow problems if they don’t get on top of their ICD-10 claims by implementing some sort of ICD-10 claims monitoring process. ICD-10 hiccups are the perfect excuse for a payer not to pay your claims.

For those that prefer a more visual approach to this discussion, Vishal and his team have put together an infographic that shares the same message as his post. Pretty cool. What won’t be cool is if you’re stuck with a lot of unpaid claims thanks to ICD-10. Make sure you and your organization are ready to deal with it.
What Are You Doing to Monitor Your Claims

Full Disclosure: ClinicSpectrum is a sponsor of EMR and HIPAA.

ICD-10 Tuesdays

Posted on November 5, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As promised, today is the start of a series of blog posts I’m calling ICD-10 Tuesdays. Every Tuesday I’m planning to publish a series of blog posts looking at the challenges and opportunities associated with the implementation of ICD-10 in the US.

I’ll do this for as long as I have interesting ICD-10 content to publish. I won’t be surprised if the series lasts until close to the ICD-10 implementation date, October 1, 2014. I’ll also be soliciting some outside experts to participate in the series as well.

This blog has always been a learning experience for me and this series will be a continuation of that trend. Hopefully you’ll add to the conversation in the comments of each post. The more perspectives given, the more we all learn. Plus, don’t be shy about suggesting other ICD-10 topics I should cover on our contact us page.

Since my love is technology, most of the posts in the ICD-10 series will touch on the technology aspects of ICD-10 in some way. Plus, I’ll likely highlight some interesting companies and people in the ICD-10 space. I’m already scheduling a Google Plus hangout talking about the ICD-10 workforce that will no doubt be part of the series. In fact, we’ll probably have a number of ICD-10 related videos in the series.

Now that you have the ICD-10 Tuesdays plan, I’ll start the series by saying that many in healthcare aren’t ready for the change. Although, even scarier is the large contingent of healthcare organizations that think they’re ready for ICD-10 and they are not. Hopefully as we dig into each aspect of ICD-10 and how it will impact the entire healthcare cycle, organizations will be made aware of places where they can work on their ICD-10 readiness.

Another topic I’m sure we’ll cover much more in the future is physician readiness for ICD-10. I’ve heard organizations say that they didn’t need to train their physicians for ICD-10. Those organizations are in for a rude awakening. In fact, I’m not too worried about the coders being ready for ICD-10. They know that they have to be able to work with ICD-10 if they want to have a job as a coder. So, they’ll be ready. The same can’t be said for doctors.

There’s a little ICD-10 flavor to get ICD-10 Tuesdays started. Much more to come.

Clinical Documentation Upgrade Critical Before ICD-10 Conversion

Posted on April 4, 2012 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

For most providers organizations, the news that ICD-10 implementation is likely to be delayed is, at minimum, a big relief.  But don’t let that lull you into a false sense of relief, suggests Priya Patel of tech consulting firm Perficient.  Even if the ICD-10 rollout is delayed — as many hope — until October 2013, it’s still going to happen.

So what can organizations due to reduce that weak feeling in the knees associated with ICD-10?  Well, generally speaking, Patel notes, your organization is already overdue for doing an ICD-10 impact assessment to figure out how to move ahead.

While the whole assessment is important, perhaps the most important element of the ICD-10 preparation process is clinical documentation assessment, Patel says. In fact, “if you choose not to assess your clinical documentation, you will certainly lose!” Patel asserts. Lose what?  Well, clinical and business effectiveness, sure, but also a great deal of money.

Right now, few doctors document efficiently enough to support coders, who are forced to do their work based on their assumptions and often, make mistakes and end up doing things over again.  As things move to ICD-10, these problems are only likely to get worse, as consistency in coding will become even more important.

Unfortunately, that’s not going to happen on its own. In fact, According to Patel, a recent study of 3,000-odd medical records across the country found that only 37 percent of physician documentation in existence would meet standards set by ICD-10.  Most organizations, in other words, will find that the documentation they have on hand is nowhere near as specific as it should be to support ICD-10 coding.

To figure out just how much your physicians need to improve before you transition to ICD-10, it’s critical to assess what clinical documentation gaps your organization faces, Patel says.

Anyone who reads Patel’s article and doesn’t see it as a red-hot wakeup call (deadline move-up or not) they’re crazy. It’s hard to argue that it will take a lot of time and physician training of doctors, coders and hospital staff.   If your clinicians don’t drill down to codes that have the clinical impact for them, and medical coders get much more training on documentation, anatomy and physiology and disases processes, things could get ugly, Patel notes.