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Icd 10 implementation readiness and revenue cycle analytics
 

Icd 10 implementation readiness and revenue cycle analytics

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We find that most analytics and revenue cycle companies are ignoring the future role coordinated medical coding will have, the transition to ICD-10, and the clinical documentation and processes on the ...

We find that most analytics and revenue cycle companies are ignoring the future role coordinated medical coding will have, the transition to ICD-10, and the clinical documentation and processes on the revenue cycle. The ICD-10 transition will re-write the book on revenue cycle management (RCM). RAC audits and Electronic Medical Records (EMRs) will be subject to a new paradigm with ICD-10.

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    Icd 10 implementation readiness and revenue cycle analytics Icd 10 implementation readiness and revenue cycle analytics Presentation Transcript

    • ICD-10 Implementation Readiness Revenue Cycle Analytics Medical Policy   October 2011 http://www.noworldborders.com Mike Arrigo Managing Partner, CEO No World Borders, Inc. For more details, assessment info [email_address] (Please send from your payor or provider email domain address)
    • ICD-10 Topics
      • Organization readiness
      • Organization impacts
      • Clinical integration and the revenue cycle
      • ICD-10 and analytics
      • Clinical scenarios
      http://www.noworldborders.com
    • Most Payers & Providers and Vendors Are Under Estimating the Joint Requirement & Analysis Time for 5010 and ICD-10
      • Coordinated preparation
      • Elevated role of the coder
      • “ RAC” or Revenue Audit Contractor (CMS
      • ICD-10 will change RAC issues
      • Change to clinical benchmarking
      • Disparities, siloed RCM systems
      http://www.noworldborders.com/HIPAA5010MigrationServices.html
    • ICD-10 Organizational Impact http://www.noworldborders.com/HIPAA5010MigrationServices.html
    • Understanding Stakeholder Impacts
      • Medical coder
      • Nursing
      • Case managers
      • Physicians
      • Health IT
      http://www.noworldborders.com
    • Organizational Capabilities Checklist
      • Clinical Integration with Revenue Cycle
      • Remediation Plan for ICD-10
      • Understanding of Contracted Health Plan Medical Policy changes under ICD-10
    • Organizational Capabilities Checklist
      • Claims Coding & Authorizations
      • Case Management Expertise
      • Experience with vendor chosen claims system
      • Experience with case management tools
      • Experience working with ICD-10 in other countries
    • Organizational Capabilities Checklist
      • Claims Adjudication
      • CMS view
      • Fraud analytics
      • ICD-10 Strategy
      • Data Warehouse
    • Organizational Capabilities Checklist
      • Business Intelligence
      • Regulatory expertise
      • Remediation areas checklist
      • Training
      • GEMS, Crosswalks – (cheap, sub-optimal)
      • Vocabulary & nomenclature
      • Medical Concepts and Medical Policy
    • Mike Arrigo Managing Partner, CEO No World Borders, Inc. For more details, assessment info [email_address] (Please send from your payor or provider email domain address)