ICD-Financial Risk Assessments should quantify both enterprise risk and ICD-10 risk related to each specialty and each area of ICD-10 clinical documentation.
Our founder and CEO Michael Arrigo wrote an in-depth macroeconomic analysis of ICD-10 financial risk entitled, Could ICD-10 Have as Big an Impact as the Mortgage Crisis? Yes. Here’s Why. Later, he was retained by a group of PhDs in Economics, a law firm, and a leading healthcare IT firm to assist in a Federal Trade Commission involving ICD-10’s economic impact, access to clinical data, and computer assisted coding.
From this vision, and these experiences our firm developed a strategy, analytics solutions and partnerships to deliver Clinically Integrated Analytics ™ that enable you to understand not only your ICD-10 Financial Risk but your ICD-10 specialty risk and ICD-10 audit risk. In addition we provide visibility into cost reducing opportunities in other areas of the health plan and health care provider’s operation using this analytic approach.
ICD-10 Crosswalk – Not a Panacea
Now that some health plans and health care providers have completed their ICD-10 Assessments many are trying to determine what to remediate and how to selectively prioritize ICD-10 clinical documentation improvement for health care providers. Health plans are prioritizing their ICD-10 remediations and should be looking at their claims mix and contracted providers as well as test plans. An ICD-10 Financial Risk Assessment should be a part of the ICD-10 Implementation Plan for a smooth ICD-10 transition.
Analytics can help. We continue to caution HIPAA Covered Entities on using magic ICD-10 crosswalk tools.
ICD-10 Predictive Analytics
ICD-10 Analytics can be used to help prioritize reimbursement variation.
ICD-10 Financial Risk Assessment – Apply ICD-9 and ICD-10 Predictive Analytics Synergistically
When reviewing claims, our approach is unique in that we review reimbursement risk by specialty in ICD-9 vs ICD-10, out of network claims, clinical notifications for specialties where reduction of malpractice insurance opportunities exist, and other factors.
Therefore your investment in ICD-9 claims analytics and ICD-10 consulting is leveraged, and usually we find much greater savings than the client invests in fees for our work.