Medicare Audit Improvement Act of 2015 Proposes Revised RAC Audits Just in time for ICD-10

HR 2156, the Medicare Audit Improvement Act of 2015 legislation proposes changes to the Recovery Audit Contractor (RAC) program just in time for ICD-10

Continue Reading Medicare Audit Improvement Act of 2015 Proposes Revised RAC Audits Just in time for ICD-10

ICD-10 Consulting Shift to Testing and Revenue Impacts

ICD-10 consulting will shift to testing and revenue cycle impacts in the next few months. Testing is the only way to ensure business continuity.

Continue Reading ICD-10 Consulting Shift to Testing and Revenue Impacts

ICD-10 Impacts Case Management and Case Management Reporting

When thinking about ICD-10 program governance, one of the key areas for both traditional Fee for Service (FFS) medicine and the transition to episodic (short-term) and longitudinal data for comparative effectiveness medicine in the Affordable Care Act is the Case Management process and supporting software and reports.

Continue Reading ICD-10 Impacts Case Management and Case Management Reporting

ICD-10 Financial Impact Assessment

ICD-10 Financial Impact Assessments should include an understanding of: ICD-10 Financial Impact to Revenue Cycle Management ICD-10 Financial Impact based on DRG shifts ICD-10 Financial Impact based on ICD-9 to ICD-10 mapping risk ICD-10 Financial Impact based on use of unspecified codes Health Information Technology (HIT) Impacts: ICD-10 Financial Impact to the Health Information Management (HIM) department ICD-10 Financial Impact to IT as distinct from the clinical applications such as resource conflicts ICD-10 Financial Impacts to training budgets, which should include the Human Resources Department ICD-10 Financial Risk and Impacts to denial management with respect to payer relations and contracting

Continue Reading ICD-10 Financial Impact Assessment

Assessing ICD-10 Financial Risk by Service Line

ICD-10 transition and risk assessment best practice by service line: Physician engagement, combined with chart audits and analytics must be used carefully in a balanced method to ensure that the ICD-10 transition works smoothly across service lines, physician groups, and financial management.

Continue Reading Assessing ICD-10 Financial Risk by Service Line

ICD-10 diagnosis and ICD-10 procedure codes impact provider patient scheduling workflow

ICD-10 will impact scheduling workflow. If your current systems capture ICD-9 codes, your IT team will need to remediate and test scheduling systems. Ultimately, an ICD-10 Financial Risk Assessment, ICD-10 testing, and ICD-10 implementation plan should comprehend ICD-10 provider scheduling.

Continue Reading ICD-10 diagnosis and ICD-10 procedure codes impact provider patient scheduling workflow

ICD-10 Crosswalk using ICD-10 Predictive Analytics

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 clinical documentation improvement for health care providers. Health plans are prioritizing their remediations and should be looking at their claims mix and contracted providers as well as test plans. An ICD-10 Risk Assessment using ICD-9 and ICD-10 predictive analytics can help.

Continue Reading ICD-10 Crosswalk using ICD-10 Predictive Analytics

10 Steps to a Successful ICD-10 Assessment and ICD-10 Transition

ICD-10 Assessments should lead to actionable approaches using an ICD-10 Financial Risk Assessment, ICD-10 Business roadmap, ICD-10 training for coders, ICD-10 training for physicians, ICD-10 specialty training, ICD-10 vendor readiness,…

Continue Reading 10 Steps to a Successful ICD-10 Assessment and ICD-10 Transition