ICD-10 Transition and Medical Policy
ICD-10 creates challenges for health plans who want to transition successfully from ICD-9 with respect to defining and redefining medical policy. This presentation addresses best practice approaches
ICD-10 creates challenges for health plans who want to transition successfully from ICD-9 with respect to defining and redefining medical policy. This presentation addresses best practice approaches
ICD-10 assessments should start with a thorough understanding of how to communicate, educate, train at all levels. Here are some topics our team can speak to for your organization including “ICD-10 Organization Strategy” and “ICD-10 and Business Continuity Planning” We have given many presentations throughout the US in the past year.
ICD-10 implementations, ICD-10 implementation consulting and ICD-10 risk management have been more popular topics on our blog so I am sharing an excerpt of slides I prepared for a recent industry conference near Washington DC the Workgroup for Electronic Data Interchange (WEDI).
Here is a summary of lessons learned from the Canadian experience with ICD-10 implementations and also importantly where the two implementations differ.
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.
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…
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.
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.
"Some venture-backed companies that serve hospitals and health insurers are getting a boost from what analysts call the “Y2K” of health care. [ ICD10 ]
If you are shopping for a tool for converting ICD-9 to ICD-10 diagnosis and procedure codes, make sure that you include subject matter experts in the area on your selection team, and create challenges for the vendors to overcome that represent real-world clinical scenarios - not canned demonstrations.
During our year-end strategic planning session we broadened our company's footprint to more accurately describe what we do. We explain the current market landscape and how we as well as…
The U.S. Department of Health and Human Services and CMS provided incentives which will improve the top line reimbursements starting 2012, but to realize this benefit, HEDIS Star Quality Rating…