Recommendations Based on 17 Months of End-To-End ICD-10 Testing with Provider Organizations and Payers
Louisville, KY – September 24, 2015 – ZirMed®, which empowers healthcare organizations to optimize revenue and population health with the nation’s only comprehensive end-to-end platform of cloud-based financial and clinical performance management solutions, announced a top-five list of strategies to help ease providers through the impending transition from ICD-9 to ICD-10.
Based on its experience conducting end-to-end testing with its clients and with payers since April 2014, the company has developed the following recommendations for providers:
- Develop a list of commonly used codes. Determine which diagnoses are most commonly used by the organization and create a chart with the correct ICD-10 codes as a quick reference to save time and reduce errors.
- Create a master list of ICD-10-related assignments. Designate responsibilities ahead of time to reduce staff confusion and frustration post-transition.
- Prioritize denied claims. The shift from ICD-9 to ICD-10 is expected to increase denials significantly. Providers should focus on appealing those claims that have the most significant revenue impact and the highest success rates and let the less impactful denials slide.
- Assess organizational workflow and revenue impact. Plan to track the organization’s performance during and after the transition. Identify problem areas quickly and take corrective action.
- Set staff up for success. Schedule fewer appointments the week after October 1 to allow extra time for coding and training questions.
One of ZirMed’s Wisconsin-based clients, ThedaCare, engaged with ZirMed early on in the planning process and shared an update on its efforts prior to go-live. Beth Malchetske, Director of Business Integration explains, “By focusing on the things we can control, we empower our teams to address issues before the transition, instead of waiting until a claim is at the payer awaiting reimbursement. And by making sure all the steps are followed, we’re ensuring our facilities get paid as quickly as possible post-go-live.”
ZirMed’s systems and solutions are completely ICD-10-compatible. The company offers a free ICD-10 readiness assessment, to help providers evaluate the impact that ICD-10 will have on their organizations. ZirMed also provides ICD-10 educational tools to its clients, including:
- The ICD Translator, which helps providers understand changes from ICD-9 to ICD-10
- A diagnostic usage report that shows each organization a list of its most commonly used diagnosis codes, sorted by volume and frequency
- A payer dashboard that sorts each organization’s top payers by volume and helps clients identify which payers are offering ICD-10 testing
“ZirMed has been hard at work to make sure that our clients have the best plan, solutions, and support to make the transition to ICD-10 as smooth as possible,” said Crystal Ewing, ZirMed Senior Business Analyst and Manager of Regulatory Strategy. “Providers should understand that they are not alone and there are products and services available to them to help them fix rejected claims, identify critical benchmarks, and prioritize training opportunities. No one knows exactly what will happen after the October 1 deadline, and there are certain to be bumps in the road, which is why contingency planning is critical.”
For more recommendations, and to learn more about ZirMed’s comprehensive ICD-10 strategy, please visit the company’s ICD-10 Resource Center.
ZirMed empowers healthcare organizations of all sizes and types to optimize revenue and population health with the nation’s only comprehensive end-to-end platform of cloud-based financial and clinical performance management solutions—including patient access, charge integrity, claims management, AR management, patient responsibility, and population health management. By combining breakthrough predictive analytics technology with innovative software development and the industry’s most advanced transactional network, ZirMed solutions extract actionable insights that improve our clients’ revenue cycles and support effective management of population health—while streamlining workflows, increasing operating efficiencies, and driving bottom-line performance. ZirMed’s technology and client support continue to be honored with top industry awards, including KLAS®, Healthcare Informatics, Best of SaaS Showplace (BoSS), and Black Book Rankings. To learn how ZirMed can help your healthcare organization boost its financial and clinical performance in an era of changing reimbursement models and rising operating costs, visit www.ZirMed.com.