The case for creating an ICD-10 command center
When the clock ticks in a new month and the entire healthcare industry is thereby mandated to begin using the new ICD-10 code set, there will most likely be glitches here and there.
But given the limited testing of claims acceptance and reimbursement that has taken place to date, it's impossible to predict with certainty whether those will be small and easily ironed out -- or significant enough to severely disrupt cash flow and launch more downstream problems.
With that in mind, some organizations are establishing ICD-10 command centers. They needn't be overly complex or expensive. One approach, for instance, is to set up a help line to triage savvy billing, IT or coding representatives, according to Denny Flint, managing partner of the Talon Group, a consultancy that provides ICD-10 and other services.
Tapping experts to solve problems as they arise
Rochester Regional Health System is among the hospitals building a war room for the ICD-10 deadline. A hand-picked squad of Rochester Regional staffers began working closely with each department and provider practice during the last year to assess readiness.
"During that time systems issues were mitigated, education and training occurred, forms and reports were corrected, created or archived, and processes were revamped as necessary," according to Diana Adam-Podgornik, Rochester Regional's coding compliance coordinator. There's more: "Dual coding was started and continues, KPI baseline measures were established and metrics developed for future monitoring," she said.
[See also: Innovation Pulse: Pick your own ICD-10 adventure.]
Steering committee members were asked to compile lists of frequently asked questions indicating the types of situations they can help out in, as well as naming a point person and listing appropriate contact information.
Adam-Podgornik said that the team is working on an attestation form for each department head to validate that readiness tasks are complete, including appointing a subject matter expert for that specific area.
Employees with questions or problems will be directed to the IT helpdesk, which is being staffed to handle extra volumes and armed with the FAQs to route calls appropriately to those subject matter experts.
Talon Group's Flint said the priority for every hospital should be on immediately fixing all "issues affecting revenue by payer, provider productivity, and medical necessity denials."
Command if you do, damned if you don't
Rochester Regional's command center is ultimately charged with aligning the best person to solve problems quickly as they arise – even though Adam-Podgornik is not actually expecting any major interruptions in early October.
"With planning, testing, education, and training behind us or in the final stretch, our hope is that all of the hard work has paid off," Adam-Podgornik said. "Once October 1 arrives it should be a non-event – just business as usual."
Therein lies the rub: Even hospitals that feel prepared for ICD-10 must have a plan to solve problems when they crop up. And they will.
So what are you doing to brace for ICD-10?