ICD-10 Preparation Proves Pointless Without Payers

By Greg Bengel, contributing writer

A recent survey reveals an alarming absence of communication between providers and payers on ICD-10

Communication with third-party payers represents a serious gap for providers when it comes to preparing for ICD-10, according to an article from EHR Intelligence. A recent survey conducted by Health Revenue Assurance Holdings (HRAA) shows that most hospitals are making strides when it comes to ICD-10 education and staff training, but few are communicating with third-party payers – a fact that EHR Intelligence says could make the staff training and education pointless, and “could prove financially crippling.” Check out the infographic associated with the survey here.

The article quotes Andrea Clark, HRAA CEO and Chairman, on staff training and education. “The turnaround was due to the fact that after the extension was put into place now budgets have been opened up to choose the vendor of choice to begin that education and training,” she is quoted. “Also, there is a mindset that you don’t want to train too far out or you don’t want to train too close, so it’s right at a sweet spot that they can do the fundamental CM and PCS training and allow the coders to apply and assign the ICD-10 in order to start reviewing data pre-Oct. 1, 2014.”

The HRAA statement provides the following statistics regarding providers:

• “78 percent have begun ICD-10 CM training for coding staff, compared to last quarter’s 60 percent;
• 64 percent have begun ICD-10 PCS training for coding staff, compared to last quarter’s 45 percent;
• 68 percent have begun document improvement education for medical staff, compared to last quarter’s 53 percent;
• 76 percent plan to dual code prior to October 1, 2014, compared to last quarter’s 69 percent.”

This will be all for naught, though, unless providers solidify working relationships with payers. The fact that most have not, Clark says, “makes me anxious for the hospitals because of the fact that that communication has not been opened and they really don’t know what their predictive financial model is going to be and how they can manage that or control it or educate the payer before Oct. 1, 2014.”

The good news is that communicating with providers and solidifying a partnership does not take long take long. EHR Intelligence reports that it could take as few as 30 days.