Global Lessons: Planning and Preparation are Keys to ICD-10 Success

Here is a summary of lessons learned from the Canadian experience with ICD-10 implementations and also importantly where the two implementations differ.

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Headline News in Healthcare is About Cost, Paperwork Reduction Rules Expected

This is a first step toward implementation of an Affordable Care Act provision that cuts red tape in the health care system. HHS estimates this will save $12 billion over ten years. Whether a patient is eligible for coverage The status of a health care claim submitted to a health insurer

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EHR Interoperability Standards

Electronic Health Records (EHR) or Electronic Medical Records (EMR) integration approaches depend on the strategy and priority in exchanging patient information between various healthcare applications, and the standards available:

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Accountable Care Organization: New Risk in ACO Model vs. Prospective Payment System

To protect against this high risk of significant financial loss, the Accountable Care Organization should plan at its inception for methods of payment and/or protection for these cases, such as secondary coverage (insurance).

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Medical Loss Ratio Provision of the Affordable Care Act – Less For ICD-10 and Other Reform Issues

on November 22, 2010 the Obama Administration's regulation implementing new standards for the “medical loss ratio” provision of the Affordable Care Act will make the insurance industry more transparent and is intended to enable consumers to purchase health insurance that provide more value for every dollar paid for premiums.

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ICD-10 Implementation Contention – Only 55 Hospitals in the U.S. Are at Stage Seven for Electronic Health Records

ICD-10 implementations have competition for resources within hospitals.  According to HIMSS Analytics, Stage seven healthcare organizations support the true sharing and use of patient data that ultimately improves process performance, quality…

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ICD-10 Implementation and Medical Management are Co-mingled with Revenue Cycles

Implementing ICD-10 is more than just IT. Medical management under ICD-10 will require a new view of clinical data and an audit trail from ICD-9 to ICD-10. An ICD-10 assessment from a knowledgeable company can help show where opportunities are for your company.

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ICD10 – Don’t Delay, Make Sure You Do an Assessment

Many providers and hospitals are putting off ICD-10 conversions, because they are already struggling with EHR and meaningful use. Funding is another challenge. Durel has heard from people who don't think ICD-10 is a big deal. He thinks otherwise. "... if you don't get it right, you're not going to get any bills out after Oct. 1, 2013," Durel said.

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Born This Way #1, Mubarek Resigns, Health Care Reform Continues

Sensationalism creates a sense of temporary urgency to know more. Mubarek steps down, Lady Gaga is #1, however, in health care reform more than 50% of all health care companies in the U.S. are not prepared for a new reimbursement system called ICD-10. This is a slow steady march to what could be a sensational event in the future. If a large percentage of health insurance firms and hospitals cannot submit or process claims in the new medical coding system, then it could lead to the next Federal bailout - but this time in health care not financial services.

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