In response to a letter to the Centers for Medicare & Medicaid Services (CMS), which expressed concern regarding the potential for an accumulation of millions of dollars in unpaid Medicare claims following the ICD-10 implementation, American Medical Association (AMA) President Robert M. Wah is urging physicians to prepare their billing cycles for the transition.
The letter, which was a joint effort from a hundred physician groups, including the AMA, expressed concern that contingency plans have not been established to prevent critical billing disruptions caused by the implementation of ICD-10, which goes in to effect October 1.
“By CMS’ own analysis, one of the most significant risks to moving to ICD-10 is the likelihood for claims processing and cash flow interruptions,” the letter states.
AMA President Wah told RevCycleIntelligence.com that the biggest concern regarding the transition to ICD-10 was demonstrated in CMS’s end-to-end testing, which found a decline in claims acceptance, from 97 percent to 81 percent, among the relatively small sample size tested.
“When this is expanded to all physicians and all claims, the results may be disastrous,” Wah said.
Wah also pointed to issues with previous HIPPA implementations, including NPI and Version 5010, which left some physicians unable to be paid by Medicare for several months.
“Some practices were at the point of being unable to make payroll for staff and needing to temporarily close the practice, or obtain lines of credit with financial institutions until processing was complete,” Wah states. “We are extremely concerned that physicians will face similar issues as a result of the switchover to ICD-10.”
To prepare for the transition, Wah is urging physicians to prepare for the federal mandate.
“Physicians will need to closely track various metrics for their claims including pending claims, rejected claims, days in accounts receivable and payments,” says Wah. “Any issues will need to be addressed and reworked as early as possible to prevent a backlog of unprocessed claims and lack of reimbursement.”
Nearterm can help you get your RCM in top shape in preparation for the ICD-10 compliance date of October 1. We offer coders, claims specialists, and billers to work onsite or remotely.
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