6. Superbill or No Superbill?: There are schools of thought out there that support two diverse opinions: (1) the superbill will die with ICD-10, (2) the superbill will not die with ICD-10. Neither can be regarded as correct without looking inward…you need to figure this out on your own by modeling some that you use. The goal is to understand the viability of your superbill. If it’s viable, you have some re-planning to do. If it’s not viable, you have a TON of re-planning to do.
7. Date of Service Impacts on Business Processes: The use of ICD-9 and ICD-10 will be driven by Date of Service. Take a look at the CMS newsletter “MLN Matters Number MM7492” (and probably a few others) to identify business processes that apply to you. You can begin to test where greater attention to DOS is necessary, or where attention to DOS needs to be introduced. The goal is to direct attention to data fields that are becoming key decision points.
8. Payer Contract Impacts: You don’t need a claim to test the legal language in your contracts. Your Payer contracting department can start “what if” dialogues with your Payers to begin assessing where language modifications are necessary to ensure everyone’s goal of “revenue neutrality.” The goal is to test each other’s general direction and begin to appreciate the extent to which your contracts need to be renegotiated, rewritten, or modified.
9. Workforce Change Management Processes: Foundationally, we are expecting many professionals to change what they’ve done for many years. Imaging coming to work one day and not being allowed to speak your native language any longer! You can test out the policies, procedures, and personnel that support significant workforce changes (yes, ICD-10 will be a significant workforce change for many individuals). The goal is to be proactive to ensure any outcome is a positive outcome.
10. Patient Access Readiness: Don’t forget about your schedulers, registrars, pre-authorization clerks, transfer centers, etc. There is a very high likelihood that they are doing their jobs faster by using ICD-9 cheat sheets they’ve built over time. The goal is to understand the impact and their skills. Do you have to send them to training, or do you have to quickly create new cheat sheets for them, or do you have to enhance technology or business processes to better enable them to do their jobs?
Brien N. Keller is a Senior Manager of Strategic Advisory Services and blogger at Santa Rosa Consulting where this article post was first published. Santa Rosa Consulting is a national provider of management consulting and information technology services to the healthcare industry. You can e-mail him at: BrienKeller@SantaRosaConsulting.com
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Category: Health Information Technology