The month of January presents opportunities to not only consider the year ahead, but also look back at the year just passed. With this in mind, we wanted to take a look at our most popular blogs from 2011. As you’ll see, most of them merit revisiting as your practice plans for the future.

• HIPAA 5010 – Understanding Two Important New Requirements. This blog focuses on two changes medical practices must make to their claims submission process to be 5010 compliant: using a physical address as the provider billing address and incorporating nine-digit ZIP codes into billing provider and service facility addresses. While many practices have made these changes, we’re finding that some still need to do so. It’s important to note that technology vendors cannot make these changes for practices; practices must make them on their own.

• How Paper Claims Will Be Impacted by 5010. This blog clears up some confusion that still exists today about how 5010 affects paper-based claims. While most providers filing claims with Medicare and other payers need to be compliant with 5010, those providers or payers who meet certain exceptions to the HIPAA requirements and still file on paper aren’t subject to 5010 requirements. If you’re among those providers, you can continue filing paper claims as always—at least for now.

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As an industry, the transition to HIPAA 5010 has been a learning opportunity – especially showing the benefits of planning and questioning a vendor’s capabilities early on. These lessons can be taken and applied to the next big transition – ICD-10, which will be the required coding set starting on October 1, 2013. Many people in the industry believe that there is plenty of time before the transition, and that they can start the transition process at a later time. However, now is the time for practices to start preparing for the coding change. So when I was recently given the opportunity to speak with a writer from For the Record about how the transition to ICD-10 would impact the industry and how practices should prepare, I was happy to share my thoughts.

At the start of this conversation, we focused on how this transition would impact everyone in the healthcare industry. It was the coders, though, that quickly became the focal point of our discussion. Specifically, we talked about the types of questions coders should be asking when preparing an ICD-10 transition plan. These questions include:

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Thank you to everyone who joined us on December 6 for our latest webinar, 5010 and ICD-10 – What You Must Know Now. During the one-hour event, industry expert, Ken Bradley, Vice President of Strategic Planning at Navicure, discussed where the industry is and where your practice should be with regards to 5010 and ICD-10; what to do if you have not begun preparing for 5010; how to fix the biggest problems practices are having with the 5010 requirements; and what steps you can take for ICD-10 revenue management success.

To learn more about how you can prepare for these two transitions, click here  to download the webinar recording.

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The HIPAA 5010 transition deadline is January 1, 2012. Is your practice prepared? If not, your bottom line will suffer.

Time is running out, but if you take the proper steps now, you can be ready. Since 5010 enables ICD-10, come January 1, the industry will have completed its first step towards ICD-10 compliance. However, ICD-10 will have a much bigger impact than 5010 and will require providers to re-think all processes. Practices must be preparing for ICD-10 now.

Join us on Tuesday, December 6 at 1:00 pm EST, for a free webinar: 5010 and ICD-10 – What You Must Know Now. Register Now.

During this hour, you’ll hear industry expert, Ken Bradley, Vice President of Strategic Planning at Navicure, discuss:

• Where the industry is and where your practice should be with regards to 5010 and ICD-10
• What to do if you have not begun preparing for 5010
• How to fix the biggest problems practices are having with the 5010 requirements
• What steps you can take for ICD-10 revenue management success

Make sure that your practice is prepared for these transitions.

 Participants can earn 1.0 Continuing Education Unit (CEU) from the American Academy of Professional Coders (AAPC) by attending.

Register Now.

Last week, I had the pleasure of attending the Medical Group Management Association’s annual meeting in Las Vegas. During the conference, I was excited to speak with other practice managers, physicians and technology vendors about the constant changes in the medical field – including how people handle ongoing issues such as denials management and revenue cycle management.

In addition to these insightful conversations, I had the honor of leading an educational session about preparing for the pending 5010 and ICD-10 transitions. During the hour, I provided tips about how every practice can prepare for the implementation of both 5010 and ICD-10, especially focusing on how practices can ensure that they have mitigated the possibility of revenue cycle disruptions during the transitions. During the session, there were many great questions and I was happy to see people starting to think about the transition to ICD-10. In addition, Healthcare Finance News wrote a quick synopsis of the session, which you can read here.

I look forward to hearing how people take these recommendations and apply them to their own practice. As your organization works towards both implementation deadlines, let everyone know how it is going by adding a comment in the boxes below.

The process of preparing for and converting to ICD-10 has many moving parts. As practices, health plans, and other vendors work toward the October 1, 2013 deadline, I have been hearing lots of questions about how to successfully manage the conversion. Today, I will answer a few of the more commonly asked questions pertaining to the conversion.

At this point, what stage should our payers be in regarding ICD-10 implementation? Should they be ahead of us?

Since payers and vendors will lay the technology groundwork for what practices must do to successfully transition to ICD-10, they should be well into their ICD-10 work plan and ahead of where practices are today. Most large health plans are in the midst of readying themselves for the new code set and may be starting small tests. It is a good idea to reach out to your payers to understand their progress to date, as well as how you can work with them to make the ICD-10 transition as smooth as possible.

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Thank you to everyone who joined us on September 22 for our latest webinar, 5010 and ICD-10: Ensure Minimal Impact for Your Practice. During the one-hour event, industry expert Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC, the American Academy of Professional Coders’ Vice President of ICD-10 Education and Training, discussed how careful planning can ensure organizations have minimal financial and operational disruptions when 5010 and ICD-10 are implemented and what steps your practice can be taking now to prepare both business and clinical staff members for the pending changes.

To learn more about how your practice can improve its ability to track quality measurements and prepare your staff for the 5010 and ICD-10 changes, click here to download the webinar recording.

This program meets AAPC guidelines for 1.0 Core A or 1.0 CPCO specialty CEUs. On Demand product requires successful completion of a Post-Test for continuing education units.

Are you prepared for the 5010 and ICD-10 transitions? If not, your business operations and clinical efforts could come to a standstill. However, careful planning can ensure that these types of disruptions do not occur. In fact, these transitions can actually be an opportunity for your organization to improve both types of operations. In this complimentary webinar, learn ways to minimize the financial impact of the 5010 and ICD-10 transitions and how to analyze the changes to clinical care that most practices will experience.

Join us on Thursday, September 22 at 1:00 pm EDT, for a free webinar: 5010 and ICD-10: Ensure Minimal Impact for Your Practice. Register now.

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On Jan. 1, 2012, healthcare claims must be received by payers using Version 5010 of the electronic transaction standards. Designed to standardize claim content and enable consistent business “conversations” among all practices and payers, Version 5010 will support improved claims filing, payment posting, eligibility verification, and other vital revenue cycle management (RCM) functions.

The transition to Version 5010 is the next evolution from Version 4010 established by the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Both efforts deal with a shift in technology and threaten significant cash flow disruptions for practices that fail to ensure compliance by the implementation deadline.

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As the deadlines for transitioning to HIPAA 5010 and ICD-10 rapidly approach, all practices are beginning to wonder what they should be doing to prepare for the changes. To help prepare practices for the transitions, we will be answering some of the most common questions about 5010 and ICD-10 in the coming months.

• How do we update to 5010? Depending on your practice’s stance, everyone will make this transition differently. A lot of this also depends on how you submit claims. For example, many clearinghouses are working to implement processes that will automatically convert data into the proper format. With that being said, every practice should check with their healthcare technology (HIT) vendors to find out what steps they will be required to take and how the transitions will impact them. If you don’t have a clearinghouse, you will have to test with every one of your direct payers.
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