The Effects of ICD-10 on Medical Payment

It’s been about five months since ICD-10, the first update to medical billing codes in nearly 30 years, took effect. After all of the concern and intense preparation both hospitals and insurance providers put into the launch, it’s a great time to wonder how things rolled out, and how have they affected medical payment?

A Fairly Smooth Transition

For the most part, considering the grand scale of unrolling such a huge list of billing codes, the transition happened pretty smoothly. Those that did happen seemed to be mostly human error—or simple mistakes that were bound to happen and were easily corrected. For example, some employees believed that codes in ICD-10 would be longer than those in ICD-9, but that simply wasn’t the case. It was a case of the changes being blown out of proportion.

Meanwhile, it seems like most large hospitals and major health plans had little trouble with the transition. Regardless of the worry of a technological breakdown—perhaps stemmed from the issues Healthcare.gov experienced when rolled out—there were no major issues, and most well prepared hospitals and health plans were able to transition easily.

No Serious Delays in Reimbursement

From most reports, reimbursements have moved smoothly as well. No health plans or healthcare providers have reported any negative impacts—at least none that are directly caused by ICD-10.

Realistically, it may still be a bit early to know if it’s having any kind of effect one way or another, but as we continue to move along under ICD-10, we’ll surely know if there has been an impact.

This is particularly good news for patients, as no delays/denials means they can still get the care they need without worry about paying the lion’s share of their hospital bill. Of course, while hospitals have trained and maybe hired new accounts receivable representatives to handle the new challenges presented by ICD-10, it’s still very important to focus on self-pay accounts as well. If any delays do occur, the constant influx from self-pay can seriously help keep a hospital operating in the black.

Still Monitoring Daily

While things are transitioning well so far, it doesn’t mean things won’t go askew in the future. When a project is as big as this, we often don’t see the larger impact until later—but that’s not to say that something will go wrong. It’s all a matter of monitoring codes submissions, denials, and every hospitals accounts receivable department.

If you have questions about how HCM can help your accounts receivable department efficiently manage the payment cycle, contact us today.

 

 


Categories: Blog