In Claim Management Best Practices, Disability Claims

The ICD-10 deadline is set for October 1st, 2015, and some practitioners are not ready to convert from ICD-9 codes. NueMD conducted a survey to examine the reasons why practitioners feel unprepared for the changeover, even though the deadline has repeatedly been pushed forward. With past deadlines having been extended there was hope that this one would be too, but with testing underway, it’s unlikely to occur at this stage.

The survey was conducted among medical practices, billing companies, and other professionals; but the majority of respondents were from small practices. With only 11% of respondents saying they are highly confident that their employees will be adequately trained by October 1st, there is a fear that small practitioners are less prepared for the transition than larger organizations.

65% of respondents are ‘highly’ or ‘significantly’ concerned about claims processing. Unfortunately, after the deadline has passed, incorrect medical codes, due to a lack of knowledge, could result in disrupted operations, inefficient claims processing, and delayed payments. Practices need to ensure that their coders, billers, and providers are comfortable with the new medical codes to minimize the impact.

27% of respondents actually stated that “There should be no transition to ICD-10,” clearly reflecting the stress they feel to deal with the issue. While this feeling may resonate among the healthcare industry, there are a number of reasons why the updated codes will be beneficial to medical practitioners and their clients. ICD-10 codes are:

  • Modernizing the medical industry, and the level of detail enhances the quality of care
  • More specific, so they can assist in improving care coordination for patients
  • Recognized internationally
  • Incorporating changes in medical terminology and knowledge over the years
  • More flexible for future expansion

To assist practitioners with the transition to ICD-10, ClaimVantage has upgraded their MDGuidelines package to allow employers, insurance carriers, and third-party administrators (TPAs) to easily transition on October 1st. For more information contact us today.

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