The Business of Healthcare

Are You Ready?

By Kim MIchael

Copyright June 2015

On October 1, 2015, CMS and the Federal Government have mandated that everyone covered by the Health Insurance Portability Act (HIPAA) must be transitioned to the ICD-10 code sets used to report medical diagnoses and inpatient procedures with the exception of outpatient procedures and physician services.

Virtually all health care providers will be affected, either directly or indirectly, by this massive overhaul of the coding system. CMS has warned, as have most healthcare professional organizations, that providers should anticipate drops in both production and revenue. They are also advising establishing temporary lines of credit that will cover from three to six months, should issues arise that would impact the Revenue Cycle.

The extended needs of dual coding will introduce a massive new learning curve and stretch internal resources to the limit; virtually every segment of the revenue cycle will feel the impact, but as provers ready themselves the question still remains "Are you ready?"

Last week I attended an HFMA meeting and one of the guest speakers was a CFO from a local hospital who had a surprising call from one of his payer insurance companies.  He light heartedly asked if they were ready for the I-10 transition and to his surprise (and dismay) they told him they were 75% ready.  The news came as a shock.  They (the hospital) had taken extraordinary pains to make sure they were ready and never thought of how their "partners" readiness could impact them, but a 25% "not ready" status could have a significant impact.

To be "ready", is to make sure that not only you, but every segment of any internal or external support service that can impact your revenue cycle, is ready as well; and to consider (and even plan) for those who can still impact your cash flow by their "unreadiness".

One sure way to do this is to take time to map out all the extenuating contingencies, every one and everything that potentially that can impact your revenue flow must be accounted for.  The good news is there is still time to plan for those who have not planned accordingly.