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ICD-10 Challenge?
Should a Practice Outsource Billing to Prepare for
Your Webinar will begin shortly...
#CureMDWebinar@Ken...
Presenter
Ken Edwards
Senior Billing Manager, CureMD
Topics to be covered
Impact of ICD-10
Vendor Readiness
Practice Readiness
Outsourced vs in-house billing
What to look for ...
Q. What is your top most concern
for ICD-10?
a. Physician documentation post ICD-10
b. Readiness of billing department
c. ...
The change that will shake the
healthcare industry
Claim errors will increase by 7%
.
.
ICD-10 changes EVERYTHING
40% increase in A/R days (CMS)
200% rise in claim denial rates (CMS)
Justify the medical treatment
Complex denial appeals
...
Scenario 1
Vendor Readiness
What should you ask your current vendor?
What is your time frame for implementation?
What tools, training, and support wil...
If your EHR Vendor does not respond in a timely manner
or
if the responses you receive are vague
Consider Switching
Scenario 2
Practice Readiness
ICD-10 will have a direct impact on physicians through:
Physician quality profiles – mortality and morbidity
Physician util...
It is estimated that physician productivity will decrease by
10%-20%
due to ICD-10 documentation
ICD-10 will infiltrate your domain
Source: American Academy of Professional Coders
Physicians
Nurses
Lab
Billing Coding
Fr...
Is your Billing department up for
the challenge?
Where do your denials stand?
Denials > 4% = poor performance
Cost per denial = $30
Benchmarking important KPIs
...
Adminis...
16 hours on ICD-10-CM
24 hours on ICD-10-PCS
10 hours on practice implementations
(AHIMA)
Started training coders?2.
Sourc...
Hiring in-house billers?
Professional coder costs $50,000.3.
A/R management?
Exceed 120 days
Periodic reports
Specialty-level comparison
.
.
.
4.
Resources for PQRS and
MU Stage 2?
5.
Is your practice on track ?
20152014
Oct Nov Dec
Ongoingpracticebefore“golive”
Ongoingpracticebefore“golive”
D
E
A
D
L
I
N...
If your practice is not
prepared for ICD-10
Consider Outsourcing!
6% increase in revenue for practices with outsourced billing.
Nearly 90% of solo and small practice physicians with in-hou...
Before outsourcing billing and collection services, practices should carefully evaluate the
company to minimize risk and l...
What is your strategy for ICD-10 so far?
a. Go at it alone
b. Outsource to a billing company
c. Bring an ICD-10 consultant...
CureMD
Value Proposition
ICD-10 ready software
We updated our cloud-based EHR in
2014, giving our providers ample of
time to practice new codes bef...
Session
QA&
Request a demo to see how CureMD can facilitate
your practice for ICD-10
Get in touch with our ICD-10 experts
at (212) 852...
Thank you
Look out for our email, containing the webinar
recording and free ICD-10 ebook
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Should a practice outsource billing to prepare for ICD-10 Challenge?

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Should a practice outsource billing to prepare for ICD-10 Challenge?

  1. 1. ICD-10 Challenge? Should a Practice Outsource Billing to Prepare for Your Webinar will begin shortly... #CureMDWebinar@Ken_Edwards01 We will be tweeting live
  2. 2. Presenter Ken Edwards Senior Billing Manager, CureMD
  3. 3. Topics to be covered Impact of ICD-10 Vendor Readiness Practice Readiness Outsourced vs in-house billing What to look for in an ideal RCM partner for ICD-10? . . . . . ICD-10
  4. 4. Q. What is your top most concern for ICD-10? a. Physician documentation post ICD-10 b. Readiness of billing department c. Readiness of your EHR vendor
  5. 5. The change that will shake the healthcare industry Claim errors will increase by 7% . . ICD-10 changes EVERYTHING
  6. 6. 40% increase in A/R days (CMS) 200% rise in claim denial rates (CMS) Justify the medical treatment Complex denial appeals .... Revenue and cashflow impact of ICD-10 Source: Centers for Medicare and Medicaid Services
  7. 7. Scenario 1 Vendor Readiness
  8. 8. What should you ask your current vendor? What is your time frame for implementation? What tools, training, and support will you provide to me and my staff so we can prepare our practice for ICD-10? Will your products be ready for the ICD-10 compliance date? Will both your EHR and practice management system solutions be able to support ICD-10? When will you be able to show me how ICD-10 will work in my EHR and practice management solutions? Will your system support both ICD-9 and ICD-10 codes? How much will you charge to upgrade to the new ICD-10-compliant solution? Does training cost extra? Will I need new hardware to accommodate your ICD-10 upgrade ? Will you help me test my ICD-10 compliant EHR and practice management system with my payers? ICD-10 Readiness Cost Implementation
  9. 9. If your EHR Vendor does not respond in a timely manner or if the responses you receive are vague Consider Switching
  10. 10. Scenario 2 Practice Readiness
  11. 11. ICD-10 will have a direct impact on physicians through: Physician quality profiles – mortality and morbidity Physician utilization profiles – efficiency of treating patients Physicians’ current and future evaluation and management levels, including pay for performance Daily workflow – (if ICD-10 is not properly implemented) . . . . Are you up for the challenge?
  12. 12. It is estimated that physician productivity will decrease by 10%-20% due to ICD-10 documentation
  13. 13. ICD-10 will infiltrate your domain Source: American Academy of Professional Coders Physicians Nurses Lab Billing Coding Front Desk Managers Clinical Area
  14. 14. Is your Billing department up for the challenge?
  15. 15. Where do your denials stand? Denials > 4% = poor performance Cost per denial = $30 Benchmarking important KPIs ... Administrative time Patient care 1.
  16. 16. 16 hours on ICD-10-CM 24 hours on ICD-10-PCS 10 hours on practice implementations (AHIMA) Started training coders?2. Source: American Health Information Management Association
  17. 17. Hiring in-house billers? Professional coder costs $50,000.3.
  18. 18. A/R management? Exceed 120 days Periodic reports Specialty-level comparison . . . 4.
  19. 19. Resources for PQRS and MU Stage 2? 5.
  20. 20. Is your practice on track ? 20152014 Oct Nov Dec Ongoingpracticebefore“golive” Ongoingpracticebefore“golive” D E A D L I N E O C T 1 2 0 1 5 PLANNING Identify resources Create project team Assess effects Create project plan Secure budget COMMUNICATIONS Inform staff Contact vendors Contact payers Monitor vendor prep Monitor payer prep TESTING High-level training for test team Level 1: internal Level 2: external COMPREHENSIVE TRAINING Documentation Coding O c t N o v D e c J a n F e b M a r A p r M a y J u n J u l A u g S e p
  21. 21. If your practice is not prepared for ICD-10 Consider Outsourcing!
  22. 22. 6% increase in revenue for practices with outsourced billing. Nearly 90% of solo and small practice physicians with in-house billers and collectors said they expect to outsource most or all their billing functions for ICD-10. Fact Source: Black Book Rankings Survey 2014 In-house vs outsourced In-house Pros Cons Outsourced Retain Control Less Expensive Close Proximity Transparent Enhanced Consistency Liabilities Hands off Staff issues Hidden Fees Higher costs
  23. 23. Before outsourcing billing and collection services, practices should carefully evaluate the company to minimize risk and lost revenue. Make sure your billing service provides you with a HIPAA-compliant Business Associate Agreement—and read it carefully. Don’t assume that billing service employees are up-to-date on federal regulations; ask about employee training. Don’t seal the deal with a handshake; make sure you have a contract that spells out the terms of service and includes details on indemnification, insurance, and termination. . . . . Choose the right billing vendor Do not select a billing company solely on low rates without considering the risk attached to it
  24. 24. What is your strategy for ICD-10 so far? a. Go at it alone b. Outsource to a billing company c. Bring an ICD-10 consultant on board
  25. 25. CureMD Value Proposition
  26. 26. ICD-10 ready software We updated our cloud-based EHR in 2014, giving our providers ample of time to practice new codes before the deadline. Our in-house experts will assist you throughout the conversion process, helping you with training and successful implementation of ICD-10. ICD-10 consultation team Still anxious about your prospects for successful ICD-10 conversion? We have a perfect solution for you. Give us your medical billing and concentrate on your patients. Billing Service
  27. 27. Session QA&
  28. 28. Request a demo to see how CureMD can facilitate your practice for ICD-10 Get in touch with our ICD-10 experts at (212) 852 0279 ext 384 For further inquiries regarding ICD-10, send us an email at healthit@curemd.com Need Help?
  29. 29. Thank you Look out for our email, containing the webinar recording and free ICD-10 ebook

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