With the upcoming coding changes there are estimates that practices will spend 3% of their annual revenues on this transition. The assumptions are that these costs will be put towards staff training, upgrading software, and changing business and clinical workflows. With MDeverywhere’s cloud based solution we consider it our job to ensure the system is compliant with the changes, and we will not charge our clients any extra fees to complete this work.
2. ICD-10 Reality
ICD-10 is the biggest change to face our industry in
decades - ICD-9 schema has been in place for 30 years!
Basically everything changes.....and the disruption is real.
• We will update our systems at no cost to you.
• Every PM system in use today is going to require, at
minimum, an upgrade and maybe a full conversion.
• Billing & Coding staff will require many hours of training
and recertification.
• We are releasing a “Sandbox” for clients to practice
with the new codes and be fully prepared for this
change.
3. ICD-10: The Reality
• Most practices simply do not have the systems, the capital,
or the training to operate effectively in the world of ICD-10.
• MDeverywhere ICD-10 Guarantee:
•Our systems will be fully ICD-10 Compliant by January 1,
2014. Guaranteed.
CMS Warning:
• Chance for disruption in cash flow is high.
• Recommends having 6 months of cash on hand.
4. Estimated Costs
Business Aspect
Typical Small
Practice
Typical Medium
Practice
Typical Large
Practice
Education $2,405 $4,745 $46,280
Process Analysis $6,900 $12,000 $48,000
Changes to Superbills $2,985 $9,950 $99,500
IT Costs $7,500 $15,000 $100,000
Increased
Documentation Costs $44,000 $178,500 $1,785,000
Cash Flow Disruption $19,500 $65,000 $650,000
TOTAL $83,290 $285,195 $2,728,780
5. Why The Change?
•ICD-10 provides more specific data than ICD-9
•Better reflects current medical practice
•Structure accommodates addition of new codes
•Expanded data capture
•Quality measurement
•Reduce coding errors
•Efficient claim submissions
•Identify fraud and abuse
•Track and respond to public
health outbreaks
•Enhanced analysis of disease patterns
6. Why Is It Such A Big Deal?
•ICD-10 provides more specific data than ICD-9
•Major change in the coding system
•14,400 ICD-9 diagnosis codes to 69,368+ ICD-10
diagnosis codes
•3,800 ICD-9 procedure codes to 72,000 ICD-10
procedure codes
•Major changes in structure of the codes
•Major changes in coding rules
•Major changes in terminology
7. Code Freeze Timeline
Effective October 1, 2015:
Make the switch to ICD-10. All services and
discharges on or after October 1, 2015 must
be coded using the ICD-10 code set.
Transactions that continue to use the ICD-9
codes will be rejected.
ICD-10 codes cannot be used prior to the
October 1, 2015 compliance date.
8. Billing And Coding Issues To Consider
•New code sets
•Dual Systems
•Claim Follow through and Resubmissions
•Productivity Issues
•Policies and Procedures
•Contracting Changes
•Denial Management
9. ICD-10 requires a hybrid approach. Traditional solutions won’t cut it.
Outsourced Billing MDeverywhere – Insourcing
Full Control
• Cash
• Real-time access to data
• Full visibility – 24/7
Fully Mobile & Accessible
• iOS
• Android
• Window
Access to line item detail by
account
Team approach to claims
processing, correspondence
management and denial
handling.
Lack of visibility
Lack of control
No Accountability
Your Options
Inhouse Billing
System Upgrades/Conversions
• Disruption
• Cost
Fixed Costs
• System – license, support &
maintenance
• Hardware
• Staff
• Claim Submission
• Office Space
• Training
Risk of Instability
• Staff Turnover
• Hiring the right expertise
Traditional Solutions Today’s Hybrid Approach
VS VS
10. Contact Us
Phone # (631) 232-4260 Option 4
Email: sales@mdeverywhere.com or
questions@mdeverywhere.com
THANK YOU