Insights from Forum Sponsor Greenway Health

If physician practices take the right steps to prepare for the ICD-10 conversion they can survive—and even thrive—after the transition.

The Oct. 1, 2015, transition to ICD-10 will affect physician practice revenue—however, whether that impact is positive or negative depends on you. Inadequate training can lead to coding errors and reimbursement delays, increased workloads may require additional staff, and failure to test with payers can cause a lag in payments. But with proper preparation, you can minimize ICD-10’s threat to your revenue and profitability.

Prepare your Finances

When it comes to practice finances, it’s best to prepare for the worst. Make sure your practice has a healthy cash flow now so that even if you do experience a drop in revenue, you’ll survive the hit.

Start by examining your financial workflow to identify and incorporate best practices for collecting payments and determine which claims you can still collect and which should be written off. This will paint a clear picture of the current state of your finances—which can help you figure out how much you’ll need on hand in October.

To start generating that additional cash flow, you might consider using a revenue cycle management service to help your practice rework claims and file secondary claims, both of which can boost your income. By increasing your revenue now, you will be in a better spot if it dips immediately after the ICD-10 deadline.

Monitor Denial Trends

As you work to improve your cash flow, you certainly don’t want to make—or repeat—costly mistakes. For example, if your practice keeps receiving a denial on a certain claim code, you want to be able to identify and fix it as soon as possible to prevent small losses from turning into significant drops in reimbursement.

And you don’t have to do this alone: Revenue cycle management services can monitor denial trends and pass that knowledge back to your practice, so you can proactively prevent denials. Your revenue cycle management team can not only explain denial trends, they can also suggest methods for improving your revenue collection. For example, front desk staff should always check patients’ insurance eligibility before appointments, and copayments should be collected at the time of service.

This will be crucial once the ICD-10 transition hits, so that your practice can quickly realize if you are making mistakes when filing claims and figure out how to fix them.

Partner with a Full-Service Billing Company

One of the benefits of working with a full-service billing company or revenue cycle management service is the ability to capitalize on economies of scale. Because these organizations process a large quantity of claims for hundreds or thousands of clients nationwide, they won’t just spot denial trends within your practice—but also denial trends across the country. This allows them to pinpoint and fix the issue, often before it impacts your practice.

The most effective billing organizations also have unique knowledge about billing for specific specialties and geographic locations, which means they know all the coding nuances and billing rules—including those related to ICD-10—for the payers you bill most often.

With the right revenue cycle management partner, your practice can survive—and even thrive—during the ICD-10 transition.

Leighton Noel is revenue cycle management specialist, Greenway Health, Birmingham, Ala.

Publication Date: Thursday, July 09, 2015