11/22/2013    Joseph Borreggine, DPM

ICD-10, a Recipe for Disaster? (Neil Hecht, DPM)

With the recent failed OBamacare roll-out for the
health insurance exchanges I would like PM news
readers to ponder the following:

With the way the new ICD-10 changes will affect
healthcare delivery next year when it goes into
effect Oct 1, 2014, I would like some to comment
positive or negative on how it will affect the
profitability of all medical practices across the
country due to the coding complexity and increased
medical record management.

I believe, this coding change, in turn, could
cause longer wait times, inability to see their
physician at appropriate times and even possibly
not at all because their physician may just leave
the practice of medicine due.

The potential ill-preparedness of CMS and other
insurance companies when we switch from ICD-9 to
ICD-10 is a mounting storm on the horizon. I opine
that no one in the general public is currently
aware of this looming disaster at this moment in
time.

This observation of another impending healthcare
reform debacle can be solely based on how the
government has handled the Obamacare roll out. So
far, under the leadership of HHS Secretary,
Kathleen Sebelius, healthcare reform's stellar
moment has been dulled unnecessarily.

Being that this transition is a just a short 10
months away will everyone be ready? The medical
profession does not seem to think so. Scary
thought if they are not.

Truly, doctors and hospitals will not continue to
work if they can't get paid because of the pending
change to ICD-10 coding along with all of it
idiosyncrasies and potentially
difficulties during its transition.

Most physicians are being told that they should
have at least 3-6 months cash or credit reserve of
operating expenses since it could take up to 120
days to get initially paid after the ICD-10 roll
out.

I also would like for someone to comment on the
current HIPAA privacy guidelines which are quite
stringent as of Sept 23, 2013 as they relate to
the Healthcare.gov site.

Now, any business or healthcare provider will be
fined heavily when privacy breaches occur and are
reported. Fines upwards of $1.5 million can and
will be levied.

It has happened already with Affinty Healthcare as
reported by CBS news:
http://www.hhs.gov/news/press/2013pres/08/20130814
a.html

How is that the Healthcare.gov website does not
have to follow these same HIPAA privacy protection
guidelines? With all the recent potential hacking
and privacy breaches going on with
healthcare information, doesn't the the federal
government who created HIPAA have to abide by
these laws?

Just some interesting issues that I believe the
unsuspecting public should know about in light of
recent news regarding the failed Obamacare roll-
out.

Joseph Borreggine, DPM, Charleston, IL,
footfixr@consolidated.net

Other messages in this thread:

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11/21/2013    Pam Thompson

RE: ICD-10, a Recipe for Disaster? (Neil Hecht, DPM)

ICD-10 has adverse financial consequences well
beyond those concerned with preparation for the
transition. A Canadian hospital study of ICD-10
implementation reported physician productivity
losses of 50% in the first month. A year later,
the loss continues, at 19%. It is unlikely that
the change-over in the U.S. will fare much better.

Anticipation of claims processing interruptions,
coding errors and other FUBAR'd but heretofore
unknown issues, are estimated to result in at
least 5 percent physician income loss, and up to a
30 percent short-term cash flow loss. Of course,
income loss is money you'll never see again.

CMS estimates that claim denials will increase 100
– 200 percent. Days in A/R (how long it takes to
pay you) will increase 20–40 percent. Claim error
rates will increase 6–10 percent based on improper
coding.

The cash flow loss could extend for three to six
months. Do you have operational capital to cover a
5 percent income loss and a 20-30 percent cash
flow loss for three months? Six months? It will be
of great benefit to prepare for the attendant
revenue interruption.

Is it possible that this will not occur? That
payers will reimburse you just like they always
do, promptly and correctly, with no untoward
delay, underpayment or calls for additional
information? That they won't take advantage of an
opportunity to use ICD-10 "problems" to advantage
themselves at physician expense?

I've recommended that my clients focus as much on
increasing revenue and decreasing costs as they do
directly preparing for the Oct 1st transition. A
healthy credit line would be helpful.

Pam Thompson, Guerrilla Podiatry,
pamthompson@guerrillapodiatry.com