The transition to ICD-10 has represented significant challenges for many providers – from significant time focused on paperwork and processes to dealing with delayed or denied claims. And there is nothing that quite gets the attention of a squeaky wheel when that wheel is cash flow. Protecting your practice – and your profits – has quickly become paramount in the midst of such a radical change in coding standards, and having a clear game plan is mission critical to get back to positive cash flow. Prior to the transition, experts warned that productivity and profits would be the two factors that will be most affected during the ICD-10 transition period, and now that we’re in a post-ICD-9 world, focusing on both must be top of mind.
According to a recent study published in the Perspectives in Health Information Management journal on the subject of ICD-9 to ICD-10 coding, “The prevailing estimate of productivity loss is typically somewhere between 30 and 50 percent”. Some results came in even higher, citing that coding is expected to take anywhere from 54 to 69 percent longer. These are sobering statistics for any provider who now finds that reality and estimates have are closely aligned, especially if you perform all of your billing tasks.
While productivity takes a bite out of the financial picture, some practices are finding denial rates making a substantial dent as well. Just prior to the transition, the Centers for Medicare and Medicaid Services estimated that denial rates would surge, rising by as much as 200 percent in the early stages of the ICD-10 implementation.
This means providers need to have the funds available up front to carry their practices through lean times. If the transition is resulting in plunging reimbursements for your practice, you’ll still need to cover staff salaries and rent in order to keep their doors open. Some providers heeded the urging of the American Medical Association to set up a line of credit and start saving months before the transition – but, in reality, most did not have the means to do so. The impact is likely to be less on a chiropractic practice than it is for a medical practice. And even if a practice was excellently prepared and codes correctly, there are issues on the payer side in the form of cash flow disruptions that are further delaying payments.
In the midst of all that is currently weighing down the ICD-10 transition, there’s good news—it doesn’t have to be so difficult. And for those who do find themselves and their practices suffering from ICD-10 issues, there are some steps you can take immediately to reverse the situation. The sooner you implement these the sooner you can get back to doing what you do best: helping your patients find health.