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Impact Assessment for ICD10 Implementation

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Impact Assessment for ICD10 Implementation

  1. 1. 1 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. MY ICD10 POSSE WEBSITEPlease go to our website http://myicd10.advancedmd.com/ anddownload our Impact Assessment Tool if you didn’t receive it viaemail.
  2. 2. http://myicd10.advancedmd.com
  3. 3. 1. Understand the basics of completing an ImpactAssessment2. Understand how to use the tools to complete anImpact Assessment3. Answer questions and get your feedbackComplete Survey – Price of today’s admission3 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information.
  4. 4. 4 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information.ICD-9TechnologyProcessesPeopleICD-10TechnologyProcessesPeopleCurrent State of your OfficeIdentifyAssessPlanBudget Future State of your OfficeWho When $$$$
  5. 5. 5 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. IDENTIFY AND LIST ALL OF YOUR OFFICE WORKFLOW PROCESSES THAT USE ICD-9CODES TODAYOffice WorkflowsPatient Financial FlowPatient DemoAppointment SchedulingAppt ConfirmationPt Check-in(Pre-Auth/Referral)Patient Clinical FlowProblem ListHistory and physicalMedicationsPatient Assessment-DocumentationOrders (Lab/x-ray)Results Processing - Inbound/outboundPatient EducationHealth Maintenance-(Health Watcher)Charge CaptureCharge slip/encounter form/super billCoding the Charge SlipClaims generationClearinghouse claims rejectionsCarrier claims rejectionsTrack and Analyze success and failuresClient perform reimbursement analysisA/R Follow-up/Decision SupportWorkflows can be found on the tab labeled -1) Project Master tab
  6. 6. 6 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. IDENTIFY AND LIST ALL OFFICE STAFF AND PROVIDERS WHO CURRENTLY WORKWITH ICD-9 CODES PHYSICIAN/OWNER NURSE MA MANAGER – ICD PROJECT TEAM BILLER – ICD PROJECT TEAM CODER – ICD PROJECT TEAM FRONT DESKOffice staff members can be found on the tab labeled –1) Project Master tab – Row 1Physician/OwnerNursesOtherClinicalStaffManagerBillingStaffCodingFrontDesk
  7. 7. 7 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. IDENTIFY AND LIST CURRENT ELECTRONIC SYSTEMS (E.G., PRACTICE MANAGEMENTSYSTEM, IN-HOUSE LAB, EHR, ETC.) THAT USE ICD-9PartnerTypeVendors/PartnersContactNameContactEmailContactPhonePM/EHR ADP AdvancedMD ICD10 Posse icd10posse@advancedmd.com 801-984-9500Ancillary Lab CorpAncillary RadiologyTechnology Systems on the tab labeled –2) Vendors Partners tab
  8. 8. Family Practice Office• 984 Unique ICD-9 Codes 2012• Top 10 ICD-9 Codes make up 33%• Top 20 ICD-9 make up 50%8 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. IDENTIFY YOUR MOST FREQUENTLY USED ICD-9 CODESDiagnosisCodeDiagnosis Description Total Cumulative % % of TotalV70.0 ROUTINE GEN MED EX@HLTH CARE FACL 2356 7% 7%780.79 OTHER MALAISE AND FATIGUE 1747 12% 5%257.2 OTHER TESTICULAR HYPOFUNCTION 1420 17% 4%V04.81 NEED PROPH VACCINATION&INOCULAT FLU 1015 20% 3%314 ADD CHLD WITHOUT MENTION HYPERACTV 870 22% 3%272.2 MIXED HYPERLIPIDEMIA 830 25% 3%268.9 UNSPECIFIED VITAMIN D DEFICIENCY 734 27% 2%244.9 UNSPECIFIED HYPOTHYROIDISM 663 29% 2%401.9 UNSPECIFIED ESSENTIAL HYPERTENSION 654 31% 2%784.1 THROAT PAIN 638 33% 2%Can be found on the tab labeled –3) Most Frequently Used DX 2012
  9. 9. 9 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. IDENTIFY AND LIST ALL OF YOUR OFFICE WORKFLOW PROCESSES THAT USE ICD-9CODES TODAY IDENTIFY AND LIST ALL OFFICE STAFF AND PROVIDERS WHO CURRENTLY WORKWITH ICD-9 CODES IDENTIFY AND LIST CURRENT ELECTRONIC SYSTEMS (E.G., PRACTICE MANAGEMENTSYSTEM, IN-HOUSE LAB, EHR, ETC.) THAT USE ICD-9 IDENTIFY YOUR MOST FREQUENTLY USED ICD-9 CODES
  10. 10. 10 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. ASSESS POSSIBLE WORK FLOW CHANGES YOU WILL NEED TO MAKE TOIMPLEMENT ICD-10 (E.G., DATA COLLECTION FORMS, ENCOUNTER FORMS,SUPERBILLS, ETC.)Office Workflows Process Step QuestionsLevelofImpactACTION PLANCharge slip/encounter form/super bill Look at the current Superbill andidentify how many codes this willtranslate into using ICD10 codes.How large with this make the ICD10charge slip? Will that size chargeslip be feasible using a printed/hardcopy? Evaluate the current chargeslip for currently used codes vs.outdated codes. Map remainingcodes from ICD9 to ICD10.HAfter evaluating the current printed superbill, theproject team determined that the new ICD10 superbillwould be over 8 pages long. The ICD10 project teamsuggest that we start using an electroning format of aCharge slip.Workflows can be found on the tab labeled -1) Project Master tab
  11. 11. HOW WILL THE LEVEL OF SPECIFICITYAFFECT• HOW THE PHYSICIAN DOCUMENTS• SITE• SPECIFICITY• LATERALITY• TIMING• MANIFESTATIONS• STAGE• STATUS• DRUG/ALCOHOL/TOBACCODEPENDENCE11 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. USING ICD-10 CODE BOOK OR SOFTWARE TOOL TO LOOK UP YOUR MOSTFREQUENTLY USED CODES AND IDENTIFY WHAT THE BEST POTENTIAL ICD-10MATCH WOULD BE
  12. 12. 12 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. ASSESS YOUR VENDORS READINESSPartnerTypeVendors/PartnersContactNameContactEmailContactPhoneWillyoubechangingorupgradingforICD10compliance?AreyouontracktomeettheOCT2014compliancedate?WillyoubetestinginpreparationforICD10?When?How?Howmuchwillthiscostourpracticetoupgrade?PM/EHR ADP AdvancedMD ICD10 Posse icd10posse@advancedmd.com 801-984-9500 Using ADP ADVANCEDMD’scloud based system, our clientshave already benefitted from ayear ofdevelopment, which wehave completed behind thescenes, to build the foundationthat will give upgradedfunctionality. ADPADVANCEDMD Users willcontinue to see theseenhancements throughout thenext two years.We are on track to a fullyfunctional and tested ICD-10 product by theOctober 2014 deadline.Yes Last Quarter 2013 As with mostenhancements, ICD-10functionality is includedin with your monthlysubscription fee.Changes to functionalitywill be included in ourgeneral releases and allofour clients will be ableto process their claimsusing the ICD-10 codes.Ancillary Lab Corp No 2nd Quarter 2014Ancillary Radiology Yes 2nd Quarter 2014Technology Systems on the tab labeled –2) Vendors Partners tab
  13. 13. 13 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. ASSESS YOUR PAYERS READINESSPayers 2012RevenueDollars2012%ofRevenueContactNameContactEmailContactPhoneWillyoubepreparedtomeettheICD-10Deadline?Whenwillyoubereadytotest?WhatareyourplansfortestingclaimscontainingICD-10codes?Howwillyouinvolveindividualofficesinthatprocess?Ifso,when?Doweneedtore-negotiateourcontractswiththispayer?IfweneedtoreSELECTION HEALTH CARE 180,730$ 27%BLUE CROSS BLUE SHIELD 122,712$ 18%UHC STATE 47,397$ 7%DESERT BENEFIT 47,249$ 7%EDUCATORS INSURANCE ASSOC 44,234$ 7%CIGNA 41,403$ 6%AETNA 35,066$ 5%ALTIUS 30,654$ 5%PUBLIC EMPLOYEES HEALTH 26,378$ 4%UHC 22,920$ 3%HUMANA 15,026$ 2%BLUE CROSS BLUE SHEILD OF SOMEWHERE 11,682$ 2%AARP 9,679$ 1%Mountain Adminstrators 9,102$ 1%MEDICARE - PART A 8,347$ 1%STATE MEDICAID 4,677$ 1%MANAGED CARE ADMIN 4,373$ 1%CIGNA of Earth 1,058$ 0%MEDICARE ADVANTAGE 967$ 0%MEDICAID 353$ 0%MAIL HANDLERS BENEFIT PLAN 169$ 0%CONNECTICUT GENERAL 145$ 0%Technology Systems on the tab labeled –4) Payers tab
  14. 14. 14 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. ASSESS POSSIBLE WORK FLOW CHANGES YOU WILL NEED TO MAKE TOIMPLEMENT ICD-10 (E.G., DATA COLLECTION FORMS, ENCOUNTER FORMS,SUPERBILLS, ETC.) USING ICD-10 CODE BOOK OR SOFTWARE TOOL TO LOOK UP YOUR MOSTFREQUENTLY USED CODES AND IDENTIFY WHAT THE BEST POTENTIAL ICD-10MATCH WOULD BE ASSESS YOUR VENDORS READINESS ASSESS YOUR PAYERS READINESS ASSESS THE NEED TO HAVE A CONSULTANT TO ASSIST YOU WITH TRANSITIONINGTO THE ICD-10 CODE SET (E.G., IDENTIFY SYSTEM CHANGES, IDENTIFY WORKFLOW CHANGES, AND CONDUCT TRAINING)
  15. 15. 15 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. PLAN AND OUTLINE HOW YOU INTEND TO TRAIN YOUR OFFICE STAFF ON THE NEWICD-10 PROCESSES PLAN WHEN TO CONDUCT THE TRAINING PLAN WHO YOU INTEND ON NEEDING TRAINING AND WHO WILL BE INVOLVED INTESTINGOffice Workflows Process Step QuestionsLevelofImpactACTION PLANCharge slip/encounter form/super bill Look at the current Superbill andidentify how many codes this willtranslate into using ICD10 codes.How large with this make the ICD10charge slip? Will that size chargeslip be feasible using a printed/hardcopy? Evaluate the current chargeslip for currently used codes vs.outdated codes. Map remainingcodes from ICD9 to ICD10.HAfter evaluating the current printed superbill, theproject team determined that the new ICD10 superbillwould be over 8 pages long. The ICD10 project teamsuggest that we start using an electroning format of aCharge slip.
  16. 16. 16 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information.IMPLEMENTING A NEW SUPER BILL PROCESS – WHO, WHEN, AND HOW MUCHWho•Entire StaffWhen•Project Team Map outprocess in their April andMay meetings•Office will meet to discussand give input May 10th•Bi-Monthly training forstaff starting Jan 2014•Bi-Monthly training testingfor staff starting Feb 2014How Much will itcost•Tasks-$7,040•Training-$6,710•Testing-$3,530•Technology-$987Purchase Feb 2014
  17. 17. 1. Don’t let this project overwhelm you2. Start now3. Answer questions and get your feedbackComplete Survey – Price of today’s admission17 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information.

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