ICD-10 and the Impact on Revenue Cycle
October 1 2013, was to mark a seismic shift in the healthcare landscape. On this date, the U.S. government was set to retire the more than 30-year-old International Classification of Diseases, 9th Revision (ICD-9) diagnosis coding standard and officially adopt its successor, ICD-10, for ambulatory services and inpatient discharges.” While the Department of Health and Human Services recently announced they will be extending this deadline, now is still time to act.
While ICD-9 is a limited structure, ICD-10 is expansive, allowing for previously unseen precision in coding, billing, and reimbursement. For instance, rather than processing a simple diagnosis of “fracture of forearm,” healthcare providers will be able to get as detailed as a “torus fracture of lower end of right radius, subsequent encounter for closed fracture with routine healing” thanks to ICD-10’s
alphanumeric language.
Being able to chart, measure, and bill against such intricacies will have long-lasting benefits for the healthcare
industry, including better patient follow-up, more accurate claims, insight into population health, analytics about pan–healthcare system diagnoses, and a decrease in fraud.
To get to this coding nirvana, the healthcare industry has to start preparing for ICD-10 now. The cutover will impact critical systems including electronic health records (EHR), billing, encoding, referral management, contract management, and test
ordering. Peripheral systems such as decision support, quality management, disease
management, clinical trials and protocols, and modeling/trends also must be upgraded to take full advantage of the new coding structure.
According to the mandating agency, the Centers for Medicare & Medicaid Services (CMS), the healthcare industry, including physicians, hospitals, insurance providers, and third-
party billers, should already have started down the ICD-10 path. CMS published a timeline recommending that the first phase of ICD-10 deployment—assessment and planning—be completed by the second quarter of 2011 and that organizations should now be well into implementation preparations.
Smooth transition, strong returns - Dublin Primacy Care Case StudyGE Healthcare - IT
A quick and cost-effective transition from paper to electronic medical records helped Dublin Primary Care streamline staffing, improve care processes, shorten the revenue cycle, and prepare for upcoming payment reform.
The document is a collection of quotes from famous leaders in various fields such as politics, business, and entertainment. It features 3 sentence quotes from leaders like Nelson Mandela, Martin Luther King Jr., Mahatma Gandhi, Winston Churchill, Abraham Lincoln, Walt Disney, Henry Ford, Bill Gates, Larry Page, and Akio Morita about topics like education, leadership, failure, success, and creativity. The quotes provide insights into these influential figures' thoughts on making positive change in the world.
The document contains quotes from many famous historical leaders on topics like leadership, life, success and overcoming challenges. The quotes are attributed to leaders such as Nelson Mandela, Martin Luther King Jr., Mahatma Gandhi, Winston Churchill, Walt Disney, Bill Gates and others.
Strengthening Financial Performance - Learn how New England Cancer Specialists increased productivity by 36%. Access the complete webinar from within the ppt.
Smooth transition, strong returns - Dublin Primacy Care Case StudyGE Healthcare - IT
A quick and cost-effective transition from paper to electronic medical records helped Dublin Primary Care streamline staffing, improve care processes, shorten the revenue cycle, and prepare for upcoming payment reform.
The document is a collection of quotes from famous leaders in various fields such as politics, business, and entertainment. It features 3 sentence quotes from leaders like Nelson Mandela, Martin Luther King Jr., Mahatma Gandhi, Winston Churchill, Abraham Lincoln, Walt Disney, Henry Ford, Bill Gates, Larry Page, and Akio Morita about topics like education, leadership, failure, success, and creativity. The quotes provide insights into these influential figures' thoughts on making positive change in the world.
The document contains quotes from many famous historical leaders on topics like leadership, life, success and overcoming challenges. The quotes are attributed to leaders such as Nelson Mandela, Martin Luther King Jr., Mahatma Gandhi, Winston Churchill, Walt Disney, Bill Gates and others.
Strengthening Financial Performance - Learn how New England Cancer Specialists increased productivity by 36%. Access the complete webinar from within the ppt.
Accountable Care Organizations - Early Lessons Learned from Strong Revenue Cy...GE Healthcare - IT
When the Centers for Medicare and Medicaid (CMS) Innovation
announced plans to select organizations for its Shared Savings
Accountable Care Organization program in April 2011 via a proposed
rule, reactions within the healthcare community were mixed. Some
were excited by the prospect of a push for more coordinated and
integrated care networks, while others criticized the specifics of the
proposal, concerned that the level of provider risk and other provisions
would make the model unsustainable over time. Subsequently, the
Centers for Medicare and Medicaid Services (CMS) issued a Final Rule
on Shared Savings Accountable Care Organizations (ACOs) that was
much more positively received throughout the healthcare community.
CMS then followed the Final Rule with an April 2012 announcement,
adding 27 initial Share Savings ACOs to its original 32 Pioneer ACO
group. With this backdrop in place, it’s clear that accountable care
is more than the latest healthcare buzzword. Today, there is a clear
change in the focus of healthcare providers, with an emphasis on
shifting the focus of payment for hospitals, physicians, and other
healthcare entities towards integrated care and a focus on value and
quality of care rather than the volume of services provided.¹
The Need to Embrace Profit Cycle Management in Healthcare - WhitepaperGE Healthcare - IT
Executive Overview
Healthcare organizations have been operating under a fee-for-service
model for many years. As such, financial leaders have become well
versed in implementing revenue cycle management systems and
processes that primarily focus on the money that comes into an
organization. Today, a new need is emerging. Healthcare reform
and other system changes are moving the industry toward hybrid
payment models such as bundled payments, shared savings, and
capitation. To thrive in this new environment, financial leaders need
to move toward profit cycle management – an emerging model
that matches the revenues from new payment models with an
improved understanding of the true costs to deliver patient care.
The result: Positive financial performance – even in the face of
declining payments – that can be reinvested in the mission to
provide better care.
The foundation of any business or household is profit, defined as
revenue net of expenses (and applicable as such even to not-for-profit
organizations). Regardless of whether you are start-up, a Fortune 500
company, or a family of four, you need to ensure that you are bringing
in more money than you are spending. In many businesses, the
formula to determine your “profitability” is fairly straightforward.
In healthcare, however, the situation is significantly more complex,
as existing and new payment models make it difficult to determine
exactly how much revenue is going to come in the door. On the cost
side, the move to accountable care and value-based payment has
shifted the management of risk and cost onto the providers and
delivery networks, yet most providers lack the tools that would
provide a detailed understanding of the costs required to deliver
quality care, especially when that care is delivered in multiple
locations. A new model of software tools is required – representing
the next generation of revenue cycle management tools and an
emerging class of healthcare cost accounting tools. The end goal?
A solution for profit cycle management that will help organizations
generate a positive financial performance and can be reinvested
in the mission to provide better care.
This change will not happen overnight. Rather, it will be an evolution
over the next five years, as integrated delivery networks update
their revenue cycle solutions to accommodate the new payment
models, and as they deploy new activity-based costing solutions.
EMR and Practice Management Replacement 101 - 8 tips to get you started (at)GE Healthcare - IT
If you are considering replacing your EMR or Practice Management Software, or both, here are some helpful tips to help optimize your investment of time and money. - 8 tips to get you started!
Optimizing Revenue Cycle Management: Centricity Business at Saint Francis Hea...GE Healthcare - IT
For large hospitals and small provider practices alike, healthcare
reform and changing reimbursement models have introduced
significant new challenges to the business. It is now more important
than ever for organizations to have a well-designed revenue cycle
management (RCM) strategy in order to optimize their revenue cycle,
prepare for change, and maximize revenue. At the same time, mergers
and acquisitions among U.S. hospitals and physician practices add to
operational complexity, and with most hospitals employing a wide
vendor portfolio of HCIT solutions, these challenges further the
importance of running a tight financial enterprise. The inability to
effectively monitor and proactively manage the revenue cycle can
destroy profitability and make it difficult to focus on what matters
most — delivering outstanding care to patients.
The document discusses different ways to express preferences in English using phrases like "like...better than...", "prefer...to...", "would rather...than...", and "(would) prefer...rather than...". It provides examples of each preference expression followed by examples of asking about preferences and responding to preference questions in short sentences.
Technical agility for an uncertain future
Uncertainty surrounding legislation, regulatory changes and payment reform bring up a critical question: which IT platform will meet our strategic goals for the future?
The presentation will tell you what a “best-of-breed” really means, and why an interoperable IT strategy will help you effectively navigate the changing healthcare landscape and achieve improved revenue cycle performance.
EMR and Practice Management Replacement 101 - 8 tips to get you started (bt)GE Healthcare - IT
If you are considering replacing your EMR or Practice Management Software, or both, here are some helpful tips to help optimize your investment of time and money. - 8 tips to get you started!
The document summarizes Centricity Practice Solution, an integrated electronic medical record and practice management system from GE Healthcare. It highlights that the system offers exceptional customization to fit a practice's unique workflows, seamless interoperability to connect to other systems, and truly progressive technologies like predictive search and tools to support new care models. The system aims to enhance clinical and financial productivity for ambulatory practices while helping them address today's healthcare challenges.
The Medical Quality Improvement Consortium from
GE Healthcare is a rapidly growing community of over 500
Centricity* Practice Solution (CPS) and Centricity EMR (CEMR)
customers who contribute de-identified patient clinical data to
a centralized data warehouse to enable quality benchmarking,
Meaningful Use reporting, public health reporting, and research
opportunities. Data from over 25,000 providers and approximately 25 million unique patient records are represented in
the data warehouse today.
Ammonoosuc Community Health Services EMR Medical Record Case StudyGE Healthcare - IT
For Ammonoosuc Community Health Services, an Electronic Medical Record proves essential in delivering award-winning care and achieving Level 3 recognition as a patient-centered medical home
Healthcare by Any Other Name - Centricity Business WhitepaperGE Healthcare - IT
This document discusses new models of healthcare delivery such as accountable care organizations and integrated health organizations that aim to improve outcomes and reduce costs through greater coordination and integration of care. It summarizes that these models seek to address long-standing issues with the traditional fragmented healthcare system such as its focus on episodic treatment rather than prevention. Critical to enabling these new models is developing an information technology infrastructure that includes electronic medical records, revenue cycle management systems, clinical decision support, and health information exchange capabilities to facilitate data sharing and population health management.
A Case Study with Orlando Health: Driving new levels of business performance ...GE Healthcare - IT
This document provides an overview of Orlando Health's revenue cycle management processes and how they use GE Healthcare's Centricity Business solution. It describes Orlando Health's accounts receivable team structure, monthly reconciliation process with payers, and how they leverage various Centricity Business modules like BAR, ETM, and Informatics to streamline workflows, reduce days in the revenue cycle, and improve financial performance.
Centricity Business is a revenue cycle management solution from GE Healthcare that supports healthcare organizations in improving profitability. It offers integrated inpatient and ambulatory revenue cycle management, support for multiple reimbursement models, and scalable tools. Centricity Business provides automation, clinical and financial interoperability, regulatory compliance support, and business intelligence dashboards to help users optimize revenue cycle processes, enhance productivity, and make data-driven decisions. It has a track record of over 40 years and proven results for large healthcare organizations.
Electronic data interchange and proactive services for Centricity revenue cycle management customers.
Centricity EDI Services combines revenue cycle expertise and proven
services to help speed up the revenue cycle and increase productivity. Proactive
monitoring and support help to detect payer issues — often before you even realize
there’s a problem.
Key features
• Tight alignment with payers ensures mandates, updates and other payer-specific adjustments are addressed and communicated
• Management of payer connections and ownership of payer issue resolution
• Web-based tracking and reporting of all pertinent data, including transaction volumes, file and claim levels, rejection highlights, and rejection details
• Best-practice workflows and automated task management to streamline follow-up
• Notification of changes in payer processing to ensure continuous transactions
Accountable Care Organizations - Early Lessons Learned from Strong Revenue Cy...GE Healthcare - IT
When the Centers for Medicare and Medicaid (CMS) Innovation
announced plans to select organizations for its Shared Savings
Accountable Care Organization program in April 2011 via a proposed
rule, reactions within the healthcare community were mixed. Some
were excited by the prospect of a push for more coordinated and
integrated care networks, while others criticized the specifics of the
proposal, concerned that the level of provider risk and other provisions
would make the model unsustainable over time. Subsequently, the
Centers for Medicare and Medicaid Services (CMS) issued a Final Rule
on Shared Savings Accountable Care Organizations (ACOs) that was
much more positively received throughout the healthcare community.
CMS then followed the Final Rule with an April 2012 announcement,
adding 27 initial Share Savings ACOs to its original 32 Pioneer ACO
group. With this backdrop in place, it’s clear that accountable care
is more than the latest healthcare buzzword. Today, there is a clear
change in the focus of healthcare providers, with an emphasis on
shifting the focus of payment for hospitals, physicians, and other
healthcare entities towards integrated care and a focus on value and
quality of care rather than the volume of services provided.¹
The Need to Embrace Profit Cycle Management in Healthcare - WhitepaperGE Healthcare - IT
Executive Overview
Healthcare organizations have been operating under a fee-for-service
model for many years. As such, financial leaders have become well
versed in implementing revenue cycle management systems and
processes that primarily focus on the money that comes into an
organization. Today, a new need is emerging. Healthcare reform
and other system changes are moving the industry toward hybrid
payment models such as bundled payments, shared savings, and
capitation. To thrive in this new environment, financial leaders need
to move toward profit cycle management – an emerging model
that matches the revenues from new payment models with an
improved understanding of the true costs to deliver patient care.
The result: Positive financial performance – even in the face of
declining payments – that can be reinvested in the mission to
provide better care.
The foundation of any business or household is profit, defined as
revenue net of expenses (and applicable as such even to not-for-profit
organizations). Regardless of whether you are start-up, a Fortune 500
company, or a family of four, you need to ensure that you are bringing
in more money than you are spending. In many businesses, the
formula to determine your “profitability” is fairly straightforward.
In healthcare, however, the situation is significantly more complex,
as existing and new payment models make it difficult to determine
exactly how much revenue is going to come in the door. On the cost
side, the move to accountable care and value-based payment has
shifted the management of risk and cost onto the providers and
delivery networks, yet most providers lack the tools that would
provide a detailed understanding of the costs required to deliver
quality care, especially when that care is delivered in multiple
locations. A new model of software tools is required – representing
the next generation of revenue cycle management tools and an
emerging class of healthcare cost accounting tools. The end goal?
A solution for profit cycle management that will help organizations
generate a positive financial performance and can be reinvested
in the mission to provide better care.
This change will not happen overnight. Rather, it will be an evolution
over the next five years, as integrated delivery networks update
their revenue cycle solutions to accommodate the new payment
models, and as they deploy new activity-based costing solutions.
EMR and Practice Management Replacement 101 - 8 tips to get you started (at)GE Healthcare - IT
If you are considering replacing your EMR or Practice Management Software, or both, here are some helpful tips to help optimize your investment of time and money. - 8 tips to get you started!
Optimizing Revenue Cycle Management: Centricity Business at Saint Francis Hea...GE Healthcare - IT
For large hospitals and small provider practices alike, healthcare
reform and changing reimbursement models have introduced
significant new challenges to the business. It is now more important
than ever for organizations to have a well-designed revenue cycle
management (RCM) strategy in order to optimize their revenue cycle,
prepare for change, and maximize revenue. At the same time, mergers
and acquisitions among U.S. hospitals and physician practices add to
operational complexity, and with most hospitals employing a wide
vendor portfolio of HCIT solutions, these challenges further the
importance of running a tight financial enterprise. The inability to
effectively monitor and proactively manage the revenue cycle can
destroy profitability and make it difficult to focus on what matters
most — delivering outstanding care to patients.
The document discusses different ways to express preferences in English using phrases like "like...better than...", "prefer...to...", "would rather...than...", and "(would) prefer...rather than...". It provides examples of each preference expression followed by examples of asking about preferences and responding to preference questions in short sentences.
Technical agility for an uncertain future
Uncertainty surrounding legislation, regulatory changes and payment reform bring up a critical question: which IT platform will meet our strategic goals for the future?
The presentation will tell you what a “best-of-breed” really means, and why an interoperable IT strategy will help you effectively navigate the changing healthcare landscape and achieve improved revenue cycle performance.
EMR and Practice Management Replacement 101 - 8 tips to get you started (bt)GE Healthcare - IT
If you are considering replacing your EMR or Practice Management Software, or both, here are some helpful tips to help optimize your investment of time and money. - 8 tips to get you started!
The document summarizes Centricity Practice Solution, an integrated electronic medical record and practice management system from GE Healthcare. It highlights that the system offers exceptional customization to fit a practice's unique workflows, seamless interoperability to connect to other systems, and truly progressive technologies like predictive search and tools to support new care models. The system aims to enhance clinical and financial productivity for ambulatory practices while helping them address today's healthcare challenges.
The Medical Quality Improvement Consortium from
GE Healthcare is a rapidly growing community of over 500
Centricity* Practice Solution (CPS) and Centricity EMR (CEMR)
customers who contribute de-identified patient clinical data to
a centralized data warehouse to enable quality benchmarking,
Meaningful Use reporting, public health reporting, and research
opportunities. Data from over 25,000 providers and approximately 25 million unique patient records are represented in
the data warehouse today.
Ammonoosuc Community Health Services EMR Medical Record Case StudyGE Healthcare - IT
For Ammonoosuc Community Health Services, an Electronic Medical Record proves essential in delivering award-winning care and achieving Level 3 recognition as a patient-centered medical home
Healthcare by Any Other Name - Centricity Business WhitepaperGE Healthcare - IT
This document discusses new models of healthcare delivery such as accountable care organizations and integrated health organizations that aim to improve outcomes and reduce costs through greater coordination and integration of care. It summarizes that these models seek to address long-standing issues with the traditional fragmented healthcare system such as its focus on episodic treatment rather than prevention. Critical to enabling these new models is developing an information technology infrastructure that includes electronic medical records, revenue cycle management systems, clinical decision support, and health information exchange capabilities to facilitate data sharing and population health management.
A Case Study with Orlando Health: Driving new levels of business performance ...GE Healthcare - IT
This document provides an overview of Orlando Health's revenue cycle management processes and how they use GE Healthcare's Centricity Business solution. It describes Orlando Health's accounts receivable team structure, monthly reconciliation process with payers, and how they leverage various Centricity Business modules like BAR, ETM, and Informatics to streamline workflows, reduce days in the revenue cycle, and improve financial performance.
Centricity Business is a revenue cycle management solution from GE Healthcare that supports healthcare organizations in improving profitability. It offers integrated inpatient and ambulatory revenue cycle management, support for multiple reimbursement models, and scalable tools. Centricity Business provides automation, clinical and financial interoperability, regulatory compliance support, and business intelligence dashboards to help users optimize revenue cycle processes, enhance productivity, and make data-driven decisions. It has a track record of over 40 years and proven results for large healthcare organizations.
Electronic data interchange and proactive services for Centricity revenue cycle management customers.
Centricity EDI Services combines revenue cycle expertise and proven
services to help speed up the revenue cycle and increase productivity. Proactive
monitoring and support help to detect payer issues — often before you even realize
there’s a problem.
Key features
• Tight alignment with payers ensures mandates, updates and other payer-specific adjustments are addressed and communicated
• Management of payer connections and ownership of payer issue resolution
• Web-based tracking and reporting of all pertinent data, including transaction volumes, file and claim levels, rejection highlights, and rejection details
• Best-practice workflows and automated task management to streamline follow-up
• Notification of changes in payer processing to ensure continuous transactions
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
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Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
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The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
ICD-10 Whitepaper - Ready or not, here comes ICD-10
1. READY
Ready or Not, Here Comes ICD-10
OR NOT
Here Comes ICD-10
ICD-10 and the Impact
on Revenue Cycle
Sponsored By:
Sponsored Material
2. Ready or Not, Here Comes ICD-10
O
ctober 1 2013, was to mark a seismic shift in the healthcare landscape. On this
date, the U.S. government was set to retire the more than 30-year-old Interna-
tional Classification of Diseases, 9th Revision (ICD-9) diagnosis coding standard
and officially adopt its successor, ICD-10, for ambulatory services and inpatient discharg-
es.” While the Department of Health and Human Services recently announced they will be
extending this deadline, now is still time to act.
While ICD-9 is a limited structure, ICD-10 is expansive, allowing for previously unseen
precision in coding, billing, and reimbursement. For instance, rather than processing a sim-
ple diagnosis of “fracture of forearm,”
healthcare providers will be able to WHAT IS THE STATUS OF ICD-10 PREPARATION
get as detailed as a “torus fracture of AT YOUR ORGANIZATION?
56%
lower end of right radius, subsequent
encounter for closed fracture with
routine healing” thanks to ICD-10’s 26%
alphanumeric language. 16%
Being able to chart, measure, and 3%
bill against such intricacies will have
We are Partway through In discovery/ We have not
long-lasting benefits for the healthcare ready now assessment started yet
Base = 242
industry, including better patient follow- SOURCE: ICD-10 Puts Revenue at Risk, HealthLeaders Media Intelligence, July 2011
up, more accurate claims, insight into
population health, analytics about pan–healthcare system diagnoses, and a decrease in fraud.
To get to this coding nirvana, the healthcare industry has to start preparing for ICD-
10 now. The cutover will impact critical systems including electronic health re-
cords (EHR), billing, encoding, referral management, contract management, and test
ordering. Peripheral systems such as decision support, quality management, disease
management, clinical trials and protocols, and modeling/trends also must be upgraded to take
full advantage of the new coding structure.
According to the mandating agency, the Centers for Medicare & Medicaid Services (CMS),
the healthcare industry, including physicians, hospitals, insurance providers, and third-
party billers, should already have started down the ICD-10 path. CMS published a timeline
recommending that the first phase of ICD-10 deployment—assessment and planning—be
completed by the second quarter of 2011 and that organizations should now be well into
implementation preparations.
2 Sponsored Material
3. Ready or Not, Here Comes ICD-10
In reality, most organizations either haven’t started ICD-10 planning or are in the
early stages. A July 2011 survey on ICD-10 readiness by the HealthLeaders Media
Intelligence Unit found that only about half (56%) were in the discovery/assessment phase.
Another 16% reported they hadn’t started the ICD-10 migration process. More than a third of
respondents hadn’t come up with a projected cost for the labor, hardware, software,
training, consultants, etc., that would be required for ICD-10 compliance.
To play catch-up, healthcare companies will have to rely on the expertise of their solutions
providers. The latest version of Centricity Business from GE Healthcare is a versatile
revenue cycle management solution that is ready to support ICD-10 requirements. The
software is designed to help organizations, which continue to face surging costs for ICD-10
and overall healthcare reform, achieve greater profitability and efficiency from the front desk
to the billing office. In addition, GE Healthcare has amassed an ICD-10 knowledgebase to
assist customers, such as hospital networks, academic medical centers, large practices,
and physician billing groups, in adapting to this new environment.
Deadline Looming
A look at the calendar shows that the ONCE ICD-10 TAKES EFFECT, DO YOU
healthcare community now has less than ANTICIPATE THAT YOUR ORGANIZATION
WILL LOSE REVENUE AS A RESULT?
two years to implement one of the most
major reforms in its history. And, as the
HealthLeaders Media Intelligence survey
respondents indicated, many haven’t
even begun preparations. 54% No 46% Yes
Though they see the potential, health-
care entities face numerous obstacles
in getting ICD-10 off the ground, such
as lack of physician cooperation, staff Base = 242
training, funding, payer readiness, and SOURCE: ICD-10 Puts Revenue at Risk, HealthLeaders Media Intelligence, July 2011
vendor readiness. Forty-one percent of
respondents to the survey attributed their organization’s lack of ICD-10 readiness to “more
pressing priorities.”
“If ICD-10 were the only thing going on, it might not seem so challenging. But
healthcare organizations are under a lot of different, simultaneous pressures,” says
3 Sponsored Material
4. Ready or Not, Here Comes ICD-10
Michael Nolte, vice president and general manager for GE Healthcare IT. Others felt they
have plenty of time or that the deadline will be extended.
Organizations mulling over ICD-10 have balked at the cost. A quarter of respondents
estimated their project costs to be more than $500,000—a tough pill to swallow in these
difficult economic times.
Some fear the effect on revenue even more than the project price tag. Forty-six percent
anticipate lost revenue from ICD-10. More than 40% expect to suffer losses between 6%
and 20%. Almost half predict those losses will drag on from six months to two years.
Respondents are concerned about a push to ICD-10 leading to incomplete physician
documentation, payers not being ready in time, coding staff mistakes, and other issues.
In addition to the financial impact, companies fret over the cultural one. “ICD-10 is like
learning a new language—it’s a completely new way of thinking,” suggests Nolte.
The complexity of ICD-10 scales with the size of the healthcare system. “If you’re a single
physician practice, ICD-10 is pretty straightforward, but a large healthcare organization will
have to do a complete review of their infrastructure,” Nolte says.
To start, organizations need to assess system and vendor readiness, training needs and
financial impact, and document any gaps. A majority of survey respondents who indicated
they completed their assessments (73%) had carried out a review of their system/vendor
readiness. But less than half (48%) had studied the financial impact. Nolte notes that a compli-
cating factor of ICD-10 is that it coincides with so many other reforms, such as meaningful use.
WHAT DO YOU FORESEE AS YOUR BIGGEST CHALLENGE OR CONCERN
IN MEETING ICD-10 READINESS?
1st 2nd 3rd 4th 5th 6th
Ranked Ranked Ranked Ranked Ranked Ranked
choice choice choice choice choice choice
Physician cooperation 34% 33% 11% 9% 9% 4%
Staff training 21% 24% 17% 19% 10% 9%
Funding 18% 9% 17% 12% 22% 21%
Payer readiness 12% 17% 22% 23% 16% 10%
Vendor readiness 8% 11% 23% 25% 18% 15%
Meeting the deadline 7% 6% 10% 12% 24% 40%
Base = 242
SOURCE: ICD-10 Puts Revenue at Risk, HealthLeaders Media Intelligence, July 2011
4 Sponsored Material
5. Ready or Not, Here Comes ICD-10
ICD-10’s Benefits
While organizations might be overwhelmed by the timing, cost, and cultural impact of
ICD-10, they have to think longer-term.
Respondents to the HealthLeaders Media Intelligence survey concede that the new
coding system will lead to improvements in evidence-based medicine, long-term
healthcare quality, reimbursement, and the strength of their organization as a whole.
The ICD-10 project team at one of the country’s leading healthcare systems, Orlando
Health in Florida, says ICD-10 will enable the organization to streamline billing and reimburse-
ment, track public health, and identify areas for improvement in administrative performance.
Inside Orlando Health: ICD-10 Prep
Orlando Health has a jump-start on its peers in terms of ICD-10 preparedness. Here are some tips
from this pioneering team:
n Set up a cross-functional team to steer ICD-10 efforts. Select a subset of employees representing
all of the impacted areas, such as coding, scheduling, systems, billing, and physician practices.
n Communicate your intent to move to ICD-10 early on. Don’t spring an ICD-10 migration on your
users. Instead, let them know as soon as you form your team and allow them to have input. Many
are aware of the impending cutover and will start to worry if they don’t see movement toward ICD-10.
n Tune in to the ICD-10 community. Sign up for updates on the standard through the Centers for
Medicare & Medicaid Services (www.cms.gov) or through industry groups such as the Healthcare
Information and Management Systems Society (www.himss.org).
n Make sure your vendor is ICD-10 ready. Vendor readiness is key. Centricity Business has native
ICD-10 support and Orlando Health is working with many of their vendors to ensure system readiness.
n Understand the roles within your organization. Orlando Health found that there were four primary
groups that interacted with codes that had to be prepared for ICD-10. Determining which users will
be impacted helps focus limited resources.
n Target ICD-10 training based on audience. Understand that physicians might absorb information
differently than coders, so adjust your education program accordingly.
n Prioritize systems for compliance. Not everything has to be ready on day one, so figure out which
applications are connected to reimbursement and make sure they are compliant with ICD-10.
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6. Ready or Not, Here Comes ICD-10
A comprehensive, private, nonprofit healthcare network, Orlando Health has more than
14,000 employees and 2,000 affiliated physicians supporting the region’s only Level One
Trauma Center for adults and pediatrics; specialty hospitals dedicated to children, women,
and babies; and a statutory teaching hospital system.
Orlando Health, which considers proper coding critical to its revenue cycle, has bumped
up against the limitations of ICD-9. “ICD-9 was initially created for statistical tracking
purposes and over the years it’s been used for billing and quality measurement,” says Tiffany
Harris, inpatient coding manager and a co-lead on the ICD-10 project team at Orlando Health.
Harris believes ICD-9’s lack of specificity has rendered it obsolete and has made it difficult
for organizations like Orlando Health to garner business improvement and insight from coding.
Eager to remedy this, Orlando Health has embraced ICD-10 migration. “In ICD-10,
you can provide greater detail for complex procedures and you’re less likely to produce
incorrect codes,” Harris says.
The organization created a high-
ly visible, cross-functional team that
“In addition, Orlando Health credits along with Tiffany Harris includes
Centricity Business as key element to Jackie Weber, manager of revenue
their ICD-10 readiness.” management training; Kristy Summers,
quality assurance manager and is led
by project manager Linda Bjorklund.
Together, they are responsible for the education, training, policies, processes, corporate
communication, and systems assessment necessary for a successful ICD-10 rollout.
Weber calls cross-functionality key to an ICD-10 deployment. “ICD-10 is not just a
systems-based change; it’s also about processes. We would have serious problems if the
project was not aligned with the business,” she says.
The team recently finished its assessment phase, studying coders, physician practices, and
other areas to understand the new standard’s impact. The early start has enabled them
to begin training users and develop an awareness of the benefits of ICD-10 among all
employees. For the past two years, Harris has been introducing users to ICD-10 root words
and coding conventions via e-mail and the corporate intranet to get them used to the new
terminology. “The way we’ve approached this has cut the anxiety level among users,” she says.
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7. Ready or Not, Here Comes ICD-10
Summers has used the opportunity to identify systems that will be affected from an
operations and reporting perspective. “We’ve prioritized the systems that must be compli-
ant for us to do business, and we’ve worked closely with vendors, including GE Healthcare,
to understand their ICD-10 remediation plans,” she says.
GE Healthcare Eases ICD-10 Compliance
Like the savvy team at Orlando Health, organizations should seek a solution that assists
in all areas of ICD-10 migration, including the obstacles of staff training and payer and
vendor readiness. They also should be on the lookout for a revenue cycle solution that
minimizes costs and features a rapid return on investment.
GE Healthcare is a strong partner to help transition organizations from ICD-9 to ICD-10.
The company’s extensive experience with ICD coding standards and intimate knowledge of
the ICD-10 landscape will enable organizations to migrate their systems in a cost-effective
and user-friendly manner.
The latest version of Centricity Business supports next-generation revenue cycle
management based on ICD-10 standards. The software streamlines administrative tasks
and accelerates revenue collection from payers to providers.
“Centricity Business is extraordinarily versatile, building on 40 years of proven revenue
cycle management experience,” Nolte says. “Customers stay well ahead of emerging health-
care reform needs with technology that seamlessly connects clinical and financial information,
supports the needs of ICD-10, and delivers top revenue cycle performance.”
Centricity Business meets emerging industry needs with a highly flexible architecture,
improves profit margins by lowering accounts receivable days, and enhances patient care
by seamlessly connecting with any EHR system.
Highlights of Centricity Business Include:
n Low-touch billing to improve the ability to meet the risks of the growing self-pay population
by reducing human touch across the patient access and revenue cycle processes
n Clinical connectivity to drive real-time clinical and financial interoperability through tighter,
closed-loop connectivity between Centricity Business and EHR
n Native ICD-10 support two years ahead of the date for regulatory compliance
n Use of virtualization to lower total cost of ownership by reducing cost to implement,
support, and maintain Centricity Business
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8. Ready or Not, Here Comes ICD-10
Get Started Now
To minimize the risk of revenue loss, organizations need to get their ICD-10 efforts under
way. And to make up for lost time, they should partner with an experienced provider such
as GE Healthcare.
Doing so is bound to speed compliance cycles, reduce costs, and shrink lost revenue.
“We want to make sure our customers are ready early and that there are no bottlenecks
in their systems,” Nolte says. Companies that look beyond the deadline will find revenue-
generating uses for ICD-10, he adds.
Failure to comply with ICD-10 will severely impact the revenue cycle. Don’t wait. Start today.
Go to: www.gehealthcare.com/centricitybusiness
for more information on ICD-10 readiness
Follow @GEHealthcareIT on Twitter
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