ICD-10 Claims Denial Risk Offset by Assured Return, Medical Practice Billing Expertise

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Software upgrades to implement. Training classes to administer. Although your medical revenue cycle management faces several ICD-10 challenges that require tackling prior to the Oct. 1, 2014 “go live,” the biggest challenge may just be keeping the lights on in the months after the deadline. That’s because there’s also the worry about reduced productivity as clinical and clerical staff deploy a vastly different code set for filing claims.

This can result from physician medical billing and coding errors, insufficient documentation and increased payer scrutiny of claims. Denial rates also may increase along with a corresponding increase in accounts receivable days.

“The impact on reimbursement is a great unknown,” said Robert Tennant, senior policy advisor for the Medical Group Management Association, noting smaller practices will feel the effects disproportionately because their business structures typically require that they divest all profit annually through disbursements to physician owners. Thus, their cash reserves are more limited than hospitals or healthcare networks. “They don’t have $1 million sitting in the bank,” said Tennant.

It’s a very real possibility…unless you have the measures in place for assured return starting now.

While ICD-10 presents a clear and present risk to your revenue cycle, however, there are steps you can take now to stay solvent if reimbursement suddenly falters.

AUDIT YOUR CLAIMS

  • Analyze your claims history to determine how many dollars are likely to be at risk.
  • Look specifically for high-volume (those you use most often) and high-dollar codes that will be put under the microscope.
  • Understand how ICD-10 will impact your revenue
  • Claims history report as part of internal audit

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COMMUNICATE WITH VENDORS

  • What upgrades will they need and how much will they cost?
  • When can pre-testing begin?

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DUAL CODING

  • In the next few months, assign dual codes (ICD-9 and ICD-10) to give ICD-10 a test drive to provide practice filing a compliant claim and highlight any weaknesses in clinical documentation. That will help to minimize delays and denials post implementation

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ASSURED RETURN

During the turbulent and unpredictable transition to ICD-10, you need some revenue assurances. revMD.com offers a unique solution, an industry leading way to offer a better value and no-risk method of healthcare revenue cycle management with Assured Return. It’s a win-win pricing for your physician medical coding, billing and collections. Unique in the industry, Assured Return ensures you come out ahead by choosing revMD.com.

There’s more to consider than just the percentage fee you pay; it’s the overall gain to your bottom line. revMD.com is uniquely qualified to merge the practice of medicine with the business of healthcare and assure your healthcare revenue cycle management.

Here’s how it works: As our industry leading methodology generates increasing returns, you pay the percentage that aligns with that bottom line gain. Simply stated, you only pay less if you receive less. You pay more if you get more.

As an example, when revMD.com partners with you at a variable rate of 7%:

With increased returns, the rate increases slightly but you always receive more than you pay. If we perform only as well as your previous partner, you pay less, just 6%. If, by some chance, we generate less revenue for you than your previous partner, you pay an even lower percentage than 6%.

Now is no time to wonder if your medical practice billing and coding team has everything it takes to ensure complete and detailed documentation that ensures PQRS compliance and withstands the weight of the ICD-10 transition. Medicine is an increasingly risky business. But when revenue becomes a win-win. It’s one less risk you take.

revMD.com is the results-proven alternative for physician revenue cycle management, with a niche specialization in medical practice coding and billing that generates unprecedented results and builds profitable medical practices. Not only is revMD.com the industry expert in physician coding, billing and collections, they are the professionals in seamless ICD-10 implementation and compliance. Leveraging a history of industry wide success spanning 26 years, revMD.com partners with medical practices throughout the U.S. to optimize revenue for hospital based and community based physicians. For more information, visit www.revmd.com.

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2013-10-24T11:14:11+00:00