The issues with improper ICD-10 usage:
Do you solely rely on the
Mapping of ICD-9 to ICD-10?
Do you rely on your EHRs to
capture ICD-10 coding and billing?
Will your clinical
documentation match the ICD-10 coding ?
If you answered yes to any or all of the above questions, be prepared
for:
Payment delays
·
What is your current claim lag (from billed to
paid)?
·
Is that changing across the transition?
·
If there is a change; which payers or business
areas?
Audits
·
Are audits increasing?
·
Are appeals related to adverse audit findings
successful?
Poor quality documentation is bad for Payers, Providers and Patients.
·
Billing accuracy
·
Quality measures
·
Population management
·
Risk management
·
Healthcare analytics
·
Patient Care
Importance of Documentation
·
Supports proper payment reduced denials
·
Assures accurate measures of quality and
efficiency
·
Assures accountability and transparency
·
Captures the level of risk and severity
·
Provides better business intelligence
·
Supports clinical research
·
Enhances communication with hospital and other
providers
Providers, coders and
administrators should have a clear understanding of the impact that ICD-10 will
have on your practice. This is not the
ICD-9 that the healthcare industry used for years.
ICD-10 will measure the service on multiple
levels:
·
Accuracy
of Service
·
Risk
·
Level of
Service
·
Type of
Service
·
Quality
Measures
ICD-10 is the next step to
Value-Based Care .
As a physician can you rely on
your system, the EHRs or Billing software to dictate the ICD-10 coding or CPT
code that should be submitted ?
Maybe the question you should
ask, will my EHRs or Billing software resolve the delay in payment or defend my
audit for the coding the system did?
We have yet to see the
parameters that CMS will place for reviews or audits.
The solution to avoiding
penalties, payment reductions or an audit is to fully understand how ICD-10 is
used and how it will impact your practice.
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.
Feel free to contact us.
FOR MORE INFORMATION
HPP Management Group, Corp.
5201 Blue Lagoon, Suite 800
Miami, FL 33126
Email: pesilverio@hppcorp.com
Website: http://www.accuchecker.com
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