ICD-10 Compliance
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.