Transcript Document
Preparing for ICD-10 Transition Teleconference Hosted by Community Health Association of Mountain/ Plains States (CHAMPS) January 30, 2013, 12:00 PM – 1:00 PM MT Presented by Gervean Williams, Director, Community Health Center Finance and Operations, National Association of Community Health Centers (NACHC) The NACHC Mission To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically competent, and community directed for all medically underserved populations. ICD – 10 Myths • • • • • • It’s not going to happen My employees are responsible for the changes It won’t require many operational changes My software vendor is responsible for the changes We have plenty of time We are ready now ICD-9 History • World Health Organization • National Center for Health Statistics Adopts ICD-9 in 1979 • ICD-9 is the International classification of diseases, 9th revision Why Change to ICD-10 • ICD-9 is over 30 years old • More specific and accurate capture of data • Improved ability to measure health care services • Alignment with WHO Timeline Date Compliance Step January 1, 2010 • Payers and providers should begin internal testing of Version 5010 standards for electronic claims Implemented December 31, • Internal testing of Version 5010 must be complete to 2010 achieve Level I Version 5010 compliance Implemented January 1, 2011 • Payers and providers should begin external testing of Version 5010 for electronic claims • CMS begins accepting Version 5010 claims Implemented • Version 4010 claims continue to be accepted December 31, 2011 January 1, 2012 October 1, 2014 • External testing of Version 5010 for electronic claims must be complete to achieve Level II Version 5010 compliance • All electronic claims must use Version 5010 • Version 4010 claims are no longer accepted • Claims for services provided on or after this date must use ICD-10 codes for medical diagnosis and inpatient procedures • CPT codes will continue to be used for outpatient services Implemented Implemented Pending Potential Impact of 5010/ICD - 10 • Information Technology • Finances • Providers and Staff IT Concerns • Impact of transaction types • IT Staff • Electronic Medical Record(EMR) • Practice Management Software (PMS) Finances • Budget considerations –Software and Hardware –Upgrades –Testing –Training • Will you be able to send claims electronically? Budget Considerations • • • • • • Software and licensing Hardware Upgrades Training Updating forms Testing MGMA Budget Sample Cost Breakdown 3 physician practice Education 2,500 Process Analysis (Consultant/Additional Staff Hrs) 7,000 Changes to Super bills (Consultant/Reprinting) 3,000 IT Costs (Upgrades/New Technology) 7,500 Increased Documentation (Dictation/New Technology) 44,000 Cash flow Disruption (Lost Production) 20,000 Total 84,000 Provider and Staff Training • Who –Providers, Clinical staff, Billing, and Finance • When –Phase training • How much – Varies depending on responsibilities Planning Needs • Assess your current systems • Identify your internal and external teams • Contact your IT and clearinghouse vendors • Develop an implementation timeline • Train, Test, Train, and Test Key Steps • • • • • • • • • • • Organize project team & resources for project completion Conduct preliminary impact analysis (mission critical issues) Create implementation timeline (need vs. nice to have) Develop ICD-10 Implementation Budget (plan more, not less) Analyze documentation needs (EMR, dictation, hand-written) Develop communication plan (special news letter, staff meetings, special sessions, etc.) Develop training plan (targeted AND integrated training) Complete information systems design & development Conduct business process analysis (optimal not perfect) Conduct needs assessment (Missed anything?) Complete deployment of system changes (test, test, final) Note: Based on AMA’s “Implementation of ICD-10…;” Chapter 4, page 45 Community Health Center Issues • Billing –UB-04 and 1500 • Uniform Data System – Table 6 • Grant Writing • Registry Resources • ICD – 10 On Demand Webinar http://www.softconference.com/nachc/slist.asp?C=2761# TID17717 • AAFP http://www.aafp.org/online/etc/medialib/aafp_org/doc uments/prac_mgt/codingresources/timeline.Par.00 01.File.tmp/ICD10Timeline.pdf • CMS Resources http://www.cms.gov/ICD10/02b_Latest_News.asp#TopOf Page Misc….Medicare Changes • • • • CR 7038 PAL 2011-04 Enrollment Application Fee (855 form) Revalidation Acknowledgements • CMS ICD-10 Planning • Priority Management Group, Inc. 2011 www.gopmg.com Contact Information http://www.nachc.com/complete-list-of-trainings.cfm Gervean Williams Director of Finance and Operations NACHC [email protected] • Thank you for your participation! • Please complete the online evaluation questionnaire. You will receive an email with a link to the evaluation. Your feedback is very valuable in helping CHAMPS develop future training programs. • There is no continuing education credit available for this event. • An archive of the event will be made available within one week of the live event on the CHAMPS website at http://www.champsonline.org/Events/DistanceLearning.html#arch tele. • Please contact Shannon Kolman at [email protected] or 303-867-9583 with any questions.