In a recent policy reversal the Centers for Medicare and Medicaid Services announced it would offer ICD-10 end-to-end testing this summer. But, testing required for a successful switch is not limited to a single payer. Chris Klitgaard, CEO of healthcare revenue cycle management company MediRevv, explains the importance of end-to-end testing, how providers can work with trading partners and tips on fixing any problems before Oct. 1.
Testing is crucial to understanding any problems that could arise after implementation. "Come Oct. 1, it's nearly a given that you’ll experience increased denials, which will have the potential to severely affect your cash flow and overall revenue cycle. The more ICD-10 glitches you can discover and resolve through testing, the fewer you'll have to resolve after implementation," says Mr. Klitgaard.
Identify key trading partners
Trading partners:
• Payers
• Billing services
• Systems providers
• Clearinghouses
"It is best to begin with your largest payers first, where if denials were to happen it would have the biggest impact on your organization," says Mr. Klitgaard. "Then simply move down the list." Ask trading partners what data they need to begin the testing process and determine when they will be ready to accept test transactions.
Create a timeline
There is less than eight months until Oct. 1. "We recommend getting your testing done as soon as possible, but no later than the end of the second quarter, as that will give you another three months to perfect the process and minimize denials," says Mr. Klitgaard.
Prepare to address potential problems
Testing will allow providers to know ahead of time what level of specificity payers are expected to see and how readily they will deny claims that do not meet those expectations. "For example, in some cases there are several new ICD-10 codes that correlate to just one comparable ICD-9 code," says Mr. Klitgaard. "More specific codes are necessary for payment to be approved even though they might not impact the amount to be paid."
Testing may also reveal coding system limitations. "Time is running out and it's best for you to put the necessary resources in place now to jumpstart your testing initiatives to ensure a successful ICD-10 implementation," says Mr. Klitgaard.
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