ICD-10 Will it Happen or Will it Not?

As of now ICD-10 is scheduled to take effect on October 1, 2015. And yes, we’ve had a “go-live” date on more than one occasion over the past several years. Hard to say whether or not it will really happen this time. Some in the industry welcome it with open arms, some prefer it go away completely. Those I have spoken with who have studied it for some time assure me it’s a much easier system with more logical way of thinking than ICD-9, which sounds good to me.  The biggest problem I see is that for many coders we have memorized the codes we use most often and coding work will be slowed down to a crawl.  For our business we plan to  bring in extra coders to help so that billing schedules can be kept. Will this be costly? Yes, but it’s just a part of doing business and keeping our clients satisfied.

Last year time and funds were spent training heavily for the transition. Once the delay was announced, I decided not to implement any more formal training until April 15th.  I believe if it is going to be postponed again, it will be done by then. Last year a 1 one year delay was a last minute addition to the SGR patch legislation passed by Congress and signed by President Obama in the spring of 2014.

Stay tuned for more information on ICD-10

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Payers – Can’t Live with ‘em and Can’t Live without ‘em

Our payers are obviously a huge part of our lives. When things are going smoothly, life is good but let one little edit get out of kilter and claims are rejected and delayed.  Claims can be paid today and then BAM all of a sudden your provider’s claims process as non-par. How could that happen? Through absolutely no fault of your own an error occurs on the payer’s part and claims are all processed incorrectly. After 45 minutes on the phone you convince the clerk that your provider is in network and you are told they will reprocess the claim, you should have payment within 30-45 more days. After a long wait you receive additional payment but of course, some are denied as duplicate, so more time is spent getting your claim paid correctly, again, through no fault of your own.  Once a claim is paid incorrectly it can turn into a nightmare to actually get the money due your provider. The key is to continue to pursue it because the provider is due the money. Once this snafoo is cleared up, you can sit back, process your claims and wait on the next one to come along. Because, it saddens me to say, that it will……

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