Transition to ICD-10 is not about being Compliant. It is an ongoing Transformation. Everyone is affected - Payers, Providers and Vendors. But physicians would be on the losing end because they are the ones submitting claims. If not submitted accurately, physicians don't get paid, plain and simple.
Getting Ready for ICD-10 means two things:
Your vendors, can only help by providing the right tools to help plan and eventually submit claims but ultimately you are responsible. If claims are not done right, you don't get paid which means you lose 100%.
A lot has been written about ICD-10, it's complications etc. so I will not harp on it here.
Some simple steps you should take are:
- Start off with your existing superbill.
- Map out the relevant ICD-9 to ICD-10 codes. Your technology partner - EHR/Billing platform should help with that.
- At the very minimum, your biller should be formally trained. I recommend the entire staff, including physicians should attend training.
- For a small practice, your Biller or Office Manager should spearhead the transition effort and guide the rest of the staff, coordinate with vendors and clearinghouse.
- Explore possible boost in overall revenue. Overall, ICD-10 has the potential to boost revenue.
- Testing - work with your technology partner and clearinghouse to send test claims.
- Most important, budget for the transition cost including cost of training so that you don't get caught with unplanned expenses.