January 21, 2015 by Greenway Health
As providers look with uncertainty toward the October deadline for ICD-10, some of their most-asked questions remain unanswered: Will the shift be delayed again? Will my revenue be impacted? Will my staff training be sufficient?
While we can’t see into the future, we do have the knowledge and insights of coding consultant Mike Enos along with Nancy Enos, one of the first in the country to be an AAPC Certified ICD-10 instructor. Together, they answer a few key questions about potential further delays and what your practice should be doing right now to get ready for the ICD-10 transition.
Q: Are we sure ICD-10 isn’t going to be delayed again?
Nancy: That is the question! My friends at the MGMA government affairs office in Washington, D.C., were as surprised as everyone else about the delay last April. They say their crystal ball is still as unreliable as it was last year, but they don’t anticipate another delay. I talked to someone from the Massachusetts Medical Society on the ground in D.C. who said that none of the legislators want to hear a word about another ICD-10 delay. They’ve been there, done that, and they’re intending to move forward. All indications say there will be no delay.
January 20, 2015 by Greenway Health
Most physicians have a firm grasp on the clinical aspects of their practices. But because they’re not directly involved in medical coding and billing, it can be difficult for them to monitor financial performance and identify changes that lead to a more profitable practice.
Dr. Bryan Jick of Fair Oaks Women’s Health experienced this first-hand when his practice went through a major transition — but his billing didn’t follow suit.
“I moved into a new office, and at the same time I moved, I added another doctor. My overhead went up quite a bit, so cash flow became a huge issue,” Dr. Jick explained. “After the move, the outgoing cash was much higher and the incoming cash didn’t match it, and we started going into the red.”
The biller on staff simply didn’t have the knowledge or experience to manage the practice through the transition. And Dr. Jick didn’t know enough about billing to identify and address that problem.
January 8, 2015 by Greenway Health
This month’s Marketplace update is brought to you by Jerry Shultz, President, Lightbeam Health.
Change is a constant in healthcare — and this year promises to be no exception. The ICD-10 transition is quickly approaching, transparency in pricing is expanding daily and the demand pendulum has swung to consumerism. In addition to these challenges, healthcare providers are facing one of the biggest changes yet: the shift in how providers get paid…from volume to value.
So how do healthcare providers successfully make this transition? To start, practices must focus on the three following key actions that serve as a framework for a comprehensive strategic plan.
Catalyst for Payment Reform recently released the National Scorecard on Payment Reform 2014, reporting that 40 percent of all commercial in-network payments classify as value-based. Still, there are many obstacles to optimizing all sources of revenue, especially because most EHR technology is engineered for fee-for-service reimbursement rather than value-based models.
January 6, 2015 by Greenway Health
Healthcare organizations have seen delay after delay in transitioning from the ICD-9 coding system to ICD-10. Originally set for 2013, the shift was pushed back most recently from Oct. 1, 2014, to Oct. 1, 2015.
But despite that additional time for practices to learn about and prepare for the transition, there are still many misconceptions surrounding the impending coding change.
Sue Bowman, senior director, coding, policy and compliance at the American Health Information Management Association (AHIMA) addresses three of those misconceptions — and explains the truth — below.
You can learn more about healthcare’s transition to ICD-10 by getting our e-Book, “Preparing for October: Revenue Cycle Management for 2015 ICD-10 Go-Live.”
December 23, 2014 by Greg Fulton
The annual fee schedule setting payment rates for treating Medicare patients will go into effect Jan. 1, 2015.
In line with much of what’s trending in healthcare payment and delivery, the fee schedule incorporates the opportunity to use health IT to drive reimbursements, as well as the new and much-discussed value-based modifier program that adds another layer to the quality reporting and payment adjustment movement.
Chronic care management expansion
The fee schedule final rule provides a monthly, per-patient payment of $40.39 for managing patients with chronic conditions. With its emphasis on care coordination, the program calls for an electronic care plan that is sharable among care teams and informed by EHR data such as problem lists, medications and medication allergies. This allows providers to supervise care delegated to clinical staff that takes up at least 20 minutes per patient per reporting period.
And in a nod to flexibility akin to 2014 meaningful use reporting, billing for this care is done through certified EHRs, but either 2011 or 2014 versions can be used — whichever is in place as of Dec. 31, 2014.
December 16, 2014 by Greenway Health
A quick glimpse behind us sometimes can reveal what we can expect in the future. If you look at the past year through the lens of the Greenway blog, you’ll see several main themes setting the scene for the upcoming year — all to be played out, day after day, within your practice.
Here are a few of Greenway’s most popular topics of the past year, and what they might mean to providers in 2015.
The ICD-10 waiting game
In 2014, the transition to ICD-10 was delayed until Oct. 2015. For some, that brought an understandable sigh of relief — the transition from approximately 14,000 codes to more than 60,000 will inevitably bring payment delays and claim denials.
In a recent post, we urge you to keep in mind that while the shift will almost certainly bring struggles, with the right preparation, your practice can be ready for the ICD-10 transition. The changeover doesn’t have to be painful. And your practice can actually benefit from the ICD-10 delay if you take advantage of the extra time to implement additional preparation strategies.