ICD-10 Compliance

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It is widely acknowledged that the implementation of ICD-10 medical code set by October 1, 2014 will have a significant impact on the operations of and systems used by healthcare organizations. Failure to transition on time could have serious fiscal and reporting consequences such as:

• Loss of CMS revenue for services provided on or after October 1, 2014
• Inaccurate pay-for-performance reporting which may result in concerns about quality
• Delays in negotiating contracts with payers and providers

Jimenez Consulting professionals have decades of experience managing large scale revenue cycle projects for healthcare organizations. We can help your organization plan and manage a successful transition. Our approach encompasses the people, processes and technologies that will be impacted:

• Clinical Departments
• Clinical Outcome Reporting
• Communications and Marketing
• Contracting
• Decision Support
• Finance
• Health information management & coding
• Information Systems including any applications involved in the delivery, billing, and reporting of services
• Legal and Compliance
• Patient financial services - billing
• Payer relation/contracting
• Providers

Below is a summary of Jimenez Consulting Solutions' 3 Phase approach to ICD-10 service delivery:

Phase 1: Plan and Analyze

• Establish governance
• Conduct awareness training
• Determine impacts on staff, information systems (affected systems, applications, databases), documentation processes and work flow; data availability and use; organizational capacity (including budget)
• Develop high level plan and budget
• Document data flows, work flows, and operations to identify processes and reports that will be affected
• Evaluate opportunities for improvement
• Assess medical record documentation practices
• Develop priorities for improvements in documentation, data capture and coding
• Develop plans to educate providers about documentation practices that is required for their specialty in the new systems
• Develop education plans for staff

Phase 2: Configure, Test and Train

• Implement and test required changes to systems
• Test transactions with payers
• Continue to assess documentation practices
• Educate coding professionals

Phase 3: Implement and Refine

• Monitor systems for errors
• Evaluate documentation and coding
• Follow up on denials
• Report and monitor impacts on reimbursement  

Jimenez Consulting Solutions has industry experts with decades of experience helping organizations like yours succeed.  We understand the regulations, we understand the business, and we understand the technology.