ROLE OF SOFTWARE VENDORS IN SUCCESSFUL ICD-10 CODING

Category: Health

As of Oct. 1, 2015, any healthcare entity in the US mandated to comply with HIPAA regulations, will start using the new ICD-10 coding system replacing the ICD-9 coding system. Every activity done under the ICD-9 coding structure, for example - patient diagnosis and claims submitting will now be under the new coding standard. Medicaid, Medicare, clearing houses and private payers need to shift their focus from ICD-9 and start implementing ICD-10 coding process, failing to do so can lead to increased denials which directly impacts the financial cycle. The ICD-9 to ICD-10 transition shift may not be a major concern for corporate run houses and hospitals as they can set aside a small portion of their investments for training and other requirements. Small clinics, group practices and individual practitioners are among those expected to face a daunting task in dealing with the new coding system. The American Medical Association (AMA) estimated around $80,000 to $2.7 million conversion expenses depending on the size of each healthcare provider. To make this transition process less cumbersome the small practitioners need to trust their software vendors. FOUR WAYS TO IDENTIFY A TRUSTABLE SOFTWARE VENDOR Assess the Impact: An experienced healthcare software vendor can help Assess the Impact the transition can have on your practice. Even the Centers for Medicare and Medicaid Services recommended all the players in the healthcare industry to assess the impact the transition can have on their services. Assessing the impact of transition, help in formulating any required measurements that can help in surviving one of the toughest periods in US medical coding history. Software Upgradation: All your existing software systems may require upgradation to support the large number of codes and the exhaustive coding process of ICD-10. The Electronic Health Records (EHR), Practice Management Systems (PMS), Coding and Billing Platforms, Health Information Management Systems (HIMS) are few systems that must be upgraded to speed up things. A vendor like Promantra which offers multiple services from coding and billing services to healthcare software development can help in Software Upgradation considering all the operations in billing process. EHR User Interface: Documentation of patient diagnosis in ICD-10 coding process will play a vital role in determining your financial success. Documentation must be accurate and HIPAA compliant, if either of them are not followed, the result can lead to increased denial percentage, thus obstructing the cash flow and leading to huge losses. The EHR must substantiate the ICD-10 coding process that possesses much detailed health information than ICD-9 coding. An experienced software vendor can assist in designing the forms and fields with utmost clinical justification for your EHR User Interface. Planning, Testing and Support: Planning, Testing and Support are the three primary services that separate a trustable software vendor from others. Before the ICD-10 implementation date, it is highly recommended that you conduct trails to identify any bugs in the software developed to prevent potential errors that can lead to delayed claims. Most of the healthcare software vendors help in planning and running the ICD-10 trials. But be wise enough to choose the vendor who can provide 24/7 support to your services.