Preparing for ICD-10 should be like cramming for the SAT's. You study the new codes. You practice using them over and over. And you exhaust all the scenarios in which you think they'll be applied in your day to day.
You should ace it, right?
In a perfect world, yes. But unlike the SAT's, ICD-10 will be “graded” by your carriers – arbiters whose own self interests are all too often at heart. And if insurance companies behave the way we suspect, some (of course, not all) of them will use the massive code set overhaul simply as a way to issue new types of payment delays.
We hope we are wrong. We hope, not only that your practice is prepared to bill and document with the increased specificity that is required, but that your carriers honor that. Gray areas bedamned.
But in case we are right, we want to help pediatric practices get out in front of payment delays as soon as possible by creating a tool that will tell us (and you) what is getting paid, and by whom, and what is getting denied, and by whom.
Starting Oct. 2, PCC will closely monitor the acceptances and denials of its own practices. This should quickly begin to tell the bigger story of the behavior of carriers across the U.S. Are they paying for the new ICD-10 codes? Which ones are they paying for? Is it a regional thing?
We're looking for trends and opportunities. We also want to collect the ICD-10 stories behind the statistics – to make this data into a dynamic document that any practice, anywhere, can use as roadmap to getting paid after Oct. 1. For example, it's Oct. 15 and your practice has received 50 ICD-10-related claim denials from “X” carrier. We want to hear about it.
So we've created a quick, six-question survey that will help you tell us what's happening with your ICD payers:
We are looking forward to hearing from you!