One strategy is to continue to move ahead on ICD-10 process impacts, systems planning, and overall budgets but depending on readiness, get your consulting firm to help with both the requirements documentation and strategies for clinical documentation that don’t’ exist now. Why? The WEDI / NCHICA timeline suggests that health care providers should have started planning for ICD-10 about 18 months before the CMS announcement of a delay.
August 28, 2012 Angela Braly, the CEO of WellPoint is stepping down.
Finally, uncertainty about ICD-10 is lifted. "...rule changes the compliance date for the ICD-10-CM and ICD-10-PCS medical data code sets (hereinafter "code sets") from October 1, 2013 to October 1, 2014."
What WSJ missed in their video recap: 15% of many muni-portfolios are NOT municipality related bonds. They are hospital revenue bonds. Buffet is the leader; average investors will now scrutinize this point and perhaps review what this means in hospital bonds and what reimbursement risks such as ICD-10 may be driving risk in the future.
CAQH CORE announced that the Centers for Medicare and Medicaid Services (CMS) issued an Interim Final Rule (IFR) with comment period – Administrative Simplification: Adoption of Operating Rules for Health Care Electronic Funds Transfers (EFT) and Remittance Advice Transactions.
Since most of the cost containment and settlement solutions vendors do charge the plan, this actually works against the health plan's ability to manage their expenses and comply with regulations. Health plans should look to solutions that support the MLR calculation and regulations, and maximize the speed and the amount of reimbursement to the provider.
We believe we can save health plans and self-funded employers 15% or more, and accelerate claims payments to providers from 90 days to 7 days. If you can do that, you can get the CFO of the healthcare organization to consider investing in the future, which includes all of the regulatory compliance work for ICD-10 and related initiatives.