What You Don't Know Now Will Hurt Your Organization Tomorrow!
ICD-10 will be one of the most significant challenges the healthcare industry will face in the next several years. Will you be ready? Recent national studies indicate this transition will cost billions of dollars to implement. Many hospitals, physician groups and other organizations have begun discussions about ICD-10 but have not begun the implementation process. Even though ICD-10 is around the corner, significant work has to be accomplished in a short period of time. The myth in the industry is this is primarily a Health Information Management or coding change, whereas in fact the impact will affect many areas of an organization. There are many steps that must be taken to implement ICD-10 from budgeting for ICD-10, creating a project team, and analyzing the impact to the documentation challenges, education and training, medical policy changes, and more associated with the rollout. It will take every organization months if not years to prepare.
It is time to get started today! Lack of preparation now will incur significant costs for your organization in denied and suspended claims, negatively impacting your revenues and your organization's day-to-day operations. Let the Blue ICD-10 Expert Team help you meet the challenge. All of our ICD-10 experts have participated in the American Health Information Management Association's (AHIMA) ICD-10 Training to validate their skills.
ICD-10 Ready: Planning for Clinical, Financial and Operational Improvement
Building an ICD-10 transition roadmap will ensure IT readiness, payer integration, and accurate quality and compliance reporting. Questions you should be asking include:
- What is the sense of urgency around ICD-10 implementation?
- What is the potential impact of ICD-10?
- What should I do right now to prepare?
- What happens if I don't prepare now?
- Does all my staff need training and how much training?
- Who do I go to for the answers?
- Who can I rely on for help?
What We Can Do
- Develop implementation guidance for your organization
- Develop work plans and timelines
- Review documentation to ensure ICD-10 compliance
- Work with your organization to assist with implementation planning and execution
- Work with providers on documentation improvement
- Provide education and training on ICD-10 inpatient and outpatient coding
- Assist the organization with post implementation challenges
Who Can I Turn To for Help?
Blue's team of industry ICD-10 expert professionals are absolutely committed to consistently providing our clients with nothing less than the finest ICD-10 Implementation, coding support, and training available. We provide fully compliant coding with industry leading turnaround time and accuracy, while ensuring optimal reimbursement. We know your time is valuable. Let us help with your implementation planning and rollout.
We strive to seamlessly integrate with your staff, quickly familiarizing ourselves with your practice and team. We then identify trends and recommend services designed to accelerate the revenue cycle or improve compliance. The result of our commitment, knowledge and expertise is a history of creating long-term relationships with measurable results. Work with leaders in the industrycall the Blue team today!
Below is an outline of the initial services Blue can provide:
Steering Committee Guidance and Oversight
We can assist in assigning steering committee responsibilities, timelines and goals. Our team will be responsible for performing the Impact and GAP Solutions Analysis with the assistance of the ICD-10 Steering Committee. The Committee should include Finance, Health Information Management, Information Systems, Compliance, Clinical, Physician and PFS representatives. Blue would be a consulting member of the ICD-10 Implementation Committee participating face-to-face with on-site meetings and/or by conference calls on a regular basis.
Project Management Oversight
Managing daily operations while implementing one or more major initiatives, such as ICD-10 implementation can be particularly challenging. Sometimes the size or number of initiatives makes it difficult to do everything well. When a project manager is needed, Blue can help. Our project managers understand the complexities of the ICD-9 to ICD-10 conversion. We will oversee the project from start to finish. The project manager will help keep the ICD-10 initiative moving forward without risking other initiatives. Our goal is to partner with you to ensure successful implementation of ICD-10. We will oversee and manage all ICD-10 activities. We will develop a current and future state business process flow which includes the documentation of process steps, standard operating procedures, and work instructions. We will identify opportunities for improvement in operational performance and notify management of issues and problems requiring immediate attention. We will ensure good communication of progress of the ICD-10 project to the Executive Steering Committee on a regular basis as well as any modifications or clarifications that need to be made. Lastly, we will help your organization avoid a revenue disruption after ICD-10 implementation.
Impact and GAP Solutions Analysis - "Where are We?" and "Where Do We Need to Be?"
The Impact and GAP Solutions Analysis will provide a foundation for defining what needs to change and when we can assist with measuring the investment of time, dollars, IT and human resources. Any area, process, contract or policy that deals with ICD-9-CM today, must be examined. Completing documentation reviews in each clinical area will be a major task in order to evaluate needs and cost for physician education as well as assessing coding personnel's skills in the areas of medical terminology, anatomy, physiology and pharmacology. Defining strengths and weaknesses will be vital during this process.
This process will identify where the gaps in people, processes, and technology create the greatest risk for strategic imperatives. Once areas of risk are identified we will implement a contingency plan across all processes to reduce risk.
We will work with internal and external parties to anticipate implementation risks and develop strategies to streamline ICD-10 implementation. In order to do this effectively a risk assessment will be conducted. We will identify risk by departments or key internal/external functions. In addition we will continuously monitor the impact on scope, schedule and costs of ICD-10.
Clinical Documentation Improvement
During this segment, as part of the Impact and GAP Solutions Analysis, we will review the hospital clinical documentation in the medical record and compare the ICD-9-CM documentation to the ICD-10 code to ensure documentation will be sufficient for ICD-10. In addition we will provide an analysis with recommendations for documentation improvement as part of your Clinical Documentation Improvement Initiatives. We will review medical records for ICD-10 readiness including documentation deficiencies with ICD-10 and mapping DRGs if applicable. After completion of the clinical documentation ICD-10 readiness review, we will educate staff and/or practitioners on ICD-10 documentation deficiencies and formulate a roadmap to compliance.
Development of the Action Plan (Roadmap)
This phase takes the outputs (strategic direction, high level review) to develop the detailed design. The design focuses on business processes that require modification and IT applications that require remediation and replacement. We create a detailed project plan based on the design that carefully balances all factors.
As part of the project scope, Blue feels it is imperative to map out the process for organizing and achieving change. We will design an approach to make sure that happens. In addition we will develop the roadmap of change initiatives and organize the teams of people responsible for getting the work done.
The Roadmap will consist of actions needed, responsible party, timeframe, expected outcomes, milestones, timelines and tools to measure success. Examples of actions in the plan will be, but not limited to, conducting a process analysis, evaluating loss of productivity, considering cash flow interruptions, reviewing budgetary implications, training physicians, coders, billers and others performing pilot testing.
Education and Training Plan Development - A Critical Step
This segment will consist of the preparation and accomplishment of ICD-10 education. A successful training plan will define the objectives, needs, timeline and methods in addition to measuring the effectiveness of the education. In the Impact and GAP Solutions Analysis we defined current skills and documentation proficiencies, therefore a training map will be designed to meet the needs of the hospital and medical practice staff and physicians. Education can be completed by internal and external sources.