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Finding the Hidden Costs of ICD-10

hidden-costsThere are a lot of moving parts when it comes to preparing for the conversion to ICD-10. You already know you have to educate your staff and revamp paper forms to accommodate the new code set, but do you know how this might affect your overall budget? Have you thought about how you’re going to prepare for these “hidden” costs of ICD-10? Here’s a few tips to help:

Hidden cost #1: Staff time. Let’s say you forget to include pre-certification and referral updates in your ICD-9-to-ICD-10 workflow gap analysis. As a result, providers and/or staff might fail to use the right codes in the pre-certification and referral processes. In addition to potential patient satisfaction problems, this oversight could lead to a costly increase in the amount of time staff must spend working with patients, payers and providers on pre-certifications and referrals.

Hidden cost #2: Incorrect reimbursement. Although ICD-10 is likely to create changes in payer reimbursement policies over time, you’ll need to keep a more immediate eye on denials to make sure ICD-10 errors don’t creep in. An even bigger potential reimbursement problem, however, is much more covert: incorrect payments. It’s a lot tougher to identify claims that aren’t denied outright, but also aren’t paid at the correct amount. Not only do incorrect payments quietly eat away at your revenue, they also take precious time to pinpoint, research and remedy. Even before ICD-10 takes effect, it would be worthwhile to investigate tools and workflows that can help you quickly spot improperly paid claims.

Hidden cost #3: Coder productivity. It’s an inescapable fact: Coders using a brand-new code set simply won’t be able to code as quickly as they do today. That means you won’t be able to get as many claims out the door every day, which will negatively affect cash flow. Some solutions—bringing extra coders on-board to fill the productivity gap or paying existing coders for overtime—also represent hidden costs that you’ll need to account for.

Taking some steps now to protect your revenue cycle may help offset the costs of ICD-10—whether hidden or not. For some other revenue cycle management suggestions, check out the white paper Seven Steps to Improve Your Practice’s Revenue Cycle Management.