ICD-10 Conversion Countdown: Are All RCM Systems Go?

ICD-10 ConversionWith just two months left before the official debut of ICD-10…and tens of thousands of new diagnostic codes…many providers may be understandably wondering if their RCM system is really prepared for this massive change.  Or, if they don’t currently have an RCM system, if a potential new one is. There’s only one way to find out ahead of time: ask the vendor. Here are the top four areas to focus on, and some recommendations of what to ask. Training. If your RCM partner is planning software updates this means your staff will need training on new templates, layouts and processes. Additionally, the ICD-10 conversion will bring with it a whole blitzkrieg of changes to workflow. Ask your partner what kind of training is available, including online and self-assessment tests. The first allows your staff to train when and where they choose. The latter indicates where staff excels and where more attention is needed. Coding. The GEMs translation tool created by CMS will be useful for easing the transition to ICD-10, but it’s not the long-term solution. In fact, there is no silver bullet; training and education are essential components of the ICD-10 migration. So while you’ll want to ask your RCM partner to explain the solution’s crosswalk or mapping strategy, you should also ask about search queries and dual coding. A savvy provider will supplement GEMs with extended search capabilities, for example, enabled by natural language parsing that allows users to input simple clinical keywords to find the appropriate code. Meanwhile, dual coding allows medical coders to use ICD-9 and ICD-10 codes in a chart simultaneously to practice using the new system before it begins to affect revenue and billing cycles. Dual coding also allows for testing with outside organizations, like payers and clearinghouses, to check that all systems are ready. Costs. Ask if there are any additional costs involved for upgrades or ongoing maintenance. Some RCM providers are issuing software upgrades, while others are producing an entirely new version of their product.  Ask if you will be charged for the software updates, and how much. A true partner will consider it part of the job to make sure the system is compliant, and not charge clients any extra fees to complete this work. Testing. External testing is a critical part of the ICD-10 conversion process, and a key factor in assuring that revenue will continue to flow after the transition. Find out when and how your RCM partner plans to test the system. Catching problems before they start affecting your bottom line will save you some headaches come transition time. And asking the right questions is the best way to verify that your RCM partner--and therefore, your organization--is ready for the ICD-10 conversion.

Join Our Newsletter

Get Updates Direct to Your Inbox. Gain access to a rich library of articles, white papers, webinars, podcasts and more. Register today to receive eMDs Insights newsletter.

*
*
*
*
Specialty *
State *