Wednesday, November 4, 2015

The Big Misconception



The Big Misconception

On October 1, 2015, physicians transitioned to ICD-10.  Many systems are there offer a system for mapping ICD-9 to ICD-10.  Once again, technology is wanting to assist on the conversion process, but :
ALERT:        The fact is :      No true crosswalk' exists between ICD-9 and ICD-10
Providers are led to believe that there EHRs (Electronic Health Record) performs and/ or captures the various quality measures:  HEDIS / Meaningful USE / PQRS and so forth. 

Coders , as well as physicians are shown to use the mapping. However, when you look at the possibilities of some diagnosis:   ICD-9 to ICD-10 

·         One to Three Mapping
·         One to Sixteen Mapping
·         One to 2,530 Mapping 

You can easily see that the structure used for the mapping is incorrect and/or nonexistent. 

The wording or condition changes. 

It is this misconception that will cause providers to be flagged or audited. 

The reality is that these systems may alert you to a possible condition or capture data that might apply to one of the measures. The question you the provider must ask:

·         Does the information qualify?
·         Is it be coded correctly?
·         Is the level of service correct or is the system upcoding?
 
EHRs and the ability to exchange health information electronically can help you provide higher quality and safer care for patients while creating tangible enhancements for your organization. EHRs help providers better manage care for patients and provide better health care by:

  • Providing accurate, up-to-date, and complete information about patients at the point of care
  • Enabling quick access to patient records for more coordinated, efficient care
  • Securely sharing electronic information with patients and other clinicians
  • Helping providers more effectively diagnose patients, reduce medical errors, and provide safer care
  • Improving patient and provider interaction and communication, as well as health care convenience
  • Enabling safer, more reliable prescribing
  • Helping promote legible, complete documentation and accurate, streamlined coding and billing
  • Enhancing privacy and security of patient data
  • Helping providers improve productivity and work-life balance
  • Enabling providers to improve efficiency and meet their business goals
  • Reducing costs through decreased paperwork, improved safety, reduced duplication of testing, and improved health.

That being said, at the end of the day, providers are ultimately responsible for submitting the charges.

The vendors have clauses in there agreements, that in the event of an AUDIT or REVIEW, they (the vendor) have no liability, since you the provider were the one that released / billed the service, you are responsible and should have known. After all, they have already collected their percentage and/or service fee, thus leaving the provider to confront the audit.  

For years, physicians have been trained to understand the coding techniques of how to use the appropriate evaluation and management (E/M) code and to qualify the level of service. How many times has CMS ( Medicare and Medicaid ) performed random audits  and made the determination that level of service does justify  services rendered ?  Physicians must understand, nothing  has changed with regards to the level of service,  medical necessity, and the relation to clinical documentation.
 
The technology of the EHRs is valid and important one designed to meet the needs of today’s healthcare. However, it cannot replace the physician, nor should it be allowed to capture or code for the physician. 

Providers should understand the ICD-10 and how it applies to clinical documentation.
Doctors are consumed with meeting the various quality measures, scoring  the Stars Rating to satisfy the plans requirements, understand the value-based model  and yet they have no time to be physicians. 

The medical community should evaluate the true and correct functions of the EHRs, and the physician should determine what is correct and appropriate to capture and submit as service provided. 

Remember the terms Fraud and Abuse, or Not Medically Necessary  have not  disappeared , they are still valid. Furthermore, the OIG has expanded review process for 2016. The provider will NOT have the excuse that the EHRs did the coding. 

The HPP Management Group has represented physicians in over 500 Medicare and Medicaid audits of overpayment assessments, has participated in more than 50 A L J hearings and has recovered millions of dollars for our clients.  

The knowledge acquired in the audits served as the basis to develop the AccuChecker Product Line, so we developed proven software that enables us to maximize recovery amounts from Audits.  

Our success is measured on key factors we treat each AUDIT with a unique approach:

 

·         Working directly with the audited physician and the key staff.
·         Our forensic analysis experience permits us to view and closely analyze each transaction denied or reduced in reimbursement by the carrier.
·         The forensic analysis includes implementing software scrubbing claims techniques that allow us to follow Medicare and Medicaid reimbursement guidelines and to prepare undisputable rebuttals to the Carriers’ decisions. .
·         Preparing a detailed rebuttal to each denial or reduction in reimbursement
·         Compiling a summary rebuttal report that includes all transactions affected 

We have assisted many physicians affected with Prepayment Review situations with Medicare and Medicaid. The Prepayment Review - a lengthy and painful process, that requires continuous scrutiny and follow up. We have been able to successfully correct every Prepayment Review with patience and creating a team effort with the medical practice.
 

FOR MORE INFORMATION

HPP Management Group, Corp.
5201 Blue Lagoon, Suite 800
Miami, FL 33126
Phone: (305) 227-2383

Email: psilben@hppcorp.com

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