Should a practice outsource billing to prepare for ICD-10 Challenge?
Should a Practice Outsource Billing to Prepare for
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Senior Billing Manager, CureMD
Topics to be covered
Impact of ICD-10
Outsourced vs in-house billing
What to look for in an ideal
RCM partner for ICD-10?
Q. What is your top most concern
a. Physician documentation post ICD-10
b. Readiness of billing department
c. Readiness of your EHR vendor
The change that will shake the
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
Revenue and cashflow impact of ICD-10
Source: Centers for Medicare and Medicaid Services
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?
If your EHR Vendor does not respond in a timely manner
if the responses you receive are vague
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?
It is estimated that physician productivity will decrease by
due to ICD-10 documentation
ICD-10 will infiltrate your domain
Source: American Academy of Professional Coders
Is your Billing department up for
Where do your denials stand?
Denials > 4% = poor performance
Cost per denial = $30
Benchmarking important KPIs
16 hours on ICD-10-CM
24 hours on ICD-10-PCS
10 hours on practice implementations
Started training coders?2.
Source: American Health Information Management Association
Hiring in-house billers?
Professional coder costs $50,000.3.
Is your practice on track ?
Oct Nov Dec
Create project team
Create project plan
Monitor vendor prep
Monitor payer prep
for test team
Level 1: internal
Level 2: external
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
If your practice is not
prepared for ICD-10
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
Source: Black Book Rankings Survey 2014
In-house vs outsourced
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
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
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
ICD-10 ready software
We updated our cloud-based EHR in
2014, giving our providers ample of
time to practice new codes before
Our in-house experts will assist you
throughout the conversion process,
helping you with training and successful
implementation of ICD-10.
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
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
Look out for our email, containing the webinar
recording and free ICD-10 ebook