“Finally Friday!” Preparing for ICD-10: Congress, Payors & You

FRIDAY June 12, 2015:

Preparing for ICD-10:

Transmit Claims Ok? Check.
Medicare Accepts Them? Check.
Commercials Accept Them? Uh. Wait…

Get for the Handouts

hey did you check out our new theme song yet?

Ok, so maybe I'm exaggerating about how bad this could be, if you're not fully prepared. And maybe I'm not.

Ok, so maybe I’m exaggerating about how bad this could be, if you’re not fully prepared. Then again… maybe not.

Ok, so, like it or not, ICD-10 seems to be on track to have the green light from the Center for Medicare and Medicaid Services (CMS) on October 1, 2015, after two major delays. While the American Medical Association (AMA) still opposes ICD-10 – for obvious reasons, since they license the CPT code set, which could be replaced by ICD-10-CM – the U.S. Congress does not seem to be willing to delay it again, although there seems to be plenty of noise about delaying its “enforcement” in the form of some kind of “grace period” or transition time, allowing physicians to somehow still get paid, even if they can’t get the coding right under the new system.

Also, we’ll discuss the three pieces of legislation now making the rounds in the U.S. House of Representatives, all calling for transition periods of some kind for the move to ICD-10. Those are H.R. 2126 (seeks an indefinite delay), H.R. 2247 (seeks an 18-month delay, dual-coding, and “minor error” forgiveness), and H.R. 2652 (seeks a 2-year grace period plus a study and report by the GAO, not CMS). The GAO is a legislative branch agency, unlike the OIG, which is an executive branch agency, reporting to the Secretary of Health and Human Services, just like CMS.

There is a lot of noise in the industry about “preparing for ICD-10” but we wanted to discuss a subject not being mentioned much: are the commercial payors ready for this or not, and have you even thought about checking that out?

Mike has 30 years of hands-on experience in all phases of healthcare provider Management, Strategy, Technology, Reengineering and Compliance.

No, no. Mike is not a shark. He’s the one with the Bigger Boat. Mike has 30 years of hands-on experience in all phases of healthcare provider Management, Strategy, Technology, Reengineering and Compliance.

So, joining us on the show to talk about what to do is Mike Magliaro, MBA, MHA, of Magliaro Advisory Services, from the San Francisco Bay Area.

Mike is highly experienced in healthcare compliance and management (he was a VP of Ambulatory Care for a major academic medical center, and CEO of a 150+ Physician Medical Group), and developed the first complete ICD-10 Compliance Program™ in 2008. Now, he is offering a free webinar series to help you get ready in the remaining four months before the October 1 “Go Live” date. These webinars are sponsored by the Region 11 Chapter of HFMA.

Mike will talk a little about the four free webinars (which we highly recommend), and will also teach us about:

  • Pre-emptive action with Payers and Patients prior to October 1
  • Continued use of both ICD-9 and ICD-10 for about two years (!)
  • Use of population management data and how it helps
    (…see, Bill and Sharon have been bugging me to do this, anyway)
  • Planning for productivity shortfalls… beyond just Coding.

This will actually give you some useful material, and is a short preview of what his webinars are like.

Watch for our handouts, be sure to review our articles, and visit this link to get agendas for Mike’s four free webinars.

Come listen to the discussion!

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