Cheers to all! Contrary to everyone’s apprehension, the healthcare sector as a whole has managed to weather the ICD-10 storm and majority of the healthcare practices have even settled into the requirement mode quite smoothly. However, fear still looms large. Despite doing things right, many practices fear loss of pay. The real cause of this fear is unfamiliarity. To mitigate uncertainties, providers need to monitor certain metrics and have appropriate mechanisms in place. In this blog we talk about some important aspects that providers need to keep tab on:
Coder Productivity
Coder’s productivity is expected to take a huge beating with the implementation of ICD-10 codes. In fact, the impact is projected to be so serious that as per a recent survey, nearly one in every two coders will be affected from the implementation.
The best way to tackle this is by providing appropriate training to your coding staff and making sure they carry out their tasks in a very meticulous manner. For this you may need to fill in the gaps in documentation, which is the chief impediment to coder productivity. This may warrant introducing certain changes to the current workflow. Using computer-assisted coding can be helpful.
Volume of concurrent and retrospective queries
Concurrent queries are the requests that are sent by the patient when they are still under the point of care of the physician. Retrospective queries are the requests that are received after the patient has been discharged.
Because of the specificity involved in the new coding system, experts are of the opinion that the volume of both queries will shoot up. The challenge therefore lies in ensuring that these volumes do not overrun your practice. The best way to tackle this is by equipping your staff with workflows which would enable them to handle these queries without any fuss. Having a system in place where your staff can prioritize these queries in terms of importance and urgency can also be helpful, say experts.
Denial Rate
Claim denial rates and account receivable days may witness a drastic jump with the introduction of ICD-10. As per reports, denial rates are projected to jump from 100% to 200% and account receivable days are also expected to double. However, experts believe, that these figures will come down eventually, as and when coders get comfortable with the new requirements. A re-look at the expertise of your coders can help you arrest the denial rates from shooting up.
Days to Final Bill (DTFB) and Days to Payment
DTFB is the duration during which you generates a bill and send it to the insurance company for payments. Days of payment is the duration it takes for a healthcare to get paid after claim submission. And yes, the latter is more related to payers than providers, but still this is an important metric to watch for. This is because if insurance companies fail to pay you as fast as before, you may end up in a financial soup.
Experts’ advice you to have a benchmark for both these metrics and make sure that you never exceed this mark. It would also be helpful to take note of which payer is taking longer than usual to make the payments and be extra cautious when dealing with these companies.
Coder questions
Increased coder questions are almost unavoidable during the first few months of ICD-10 implementation and you need to be prepared to handle these questions. Yes, there are numerous external bodies such as the American Hospital Association’s Coding Clinic to guide coders, but taking matters into your own hand can be very helpful. This includes, introducing an integrated system, designed to monitor and help coders with expert guidance. Negligence in building appropriate mechanisms or monitoring this information can result in delays and inconsistent coding procedures.
Whatever is your problem we are here to help!
Our established mechanisms and expert coders are available 24×7 to help you resolve the initials glitches, and establish a smoother and leaner ICD-10 implementation. We provide you the training and support mechanism to enable you go a long way in handling and prioritizing the increased volumes of queries. And finally, we offer integrated system that monitors the key metrics, and helps you in making sure that your revenue cycle is intact and your account receivable days never shoot up.
