How do you get 104 physicians of various specialties in more than 50 offices to acknowledge, understand, and educate themselves about the coming ICD-10 transition? The key is communication, according to Alyson Tiedeman, director of practice management for South Florida Medicine.
Tiedeman was a co-presenter for "Best Practices for ICD-10 Success" at the 2014 Medical Group Management Association Annual Conference on Tues., Oct. 28, with Albert Santalo, chairman, president, and CEO of CareCloud, a cloud-based software solutions firm. South Florida Medicine, a large multi-specialty group practice headquartered in Wellington, Fla., includes physicians in urology, oncology, surgery, surgical oncology, thoracic surgery, and radiation.
When the ICD-10 code set transition was delayed to Oct. 1, 2015, Tiedeman put the brakes on preparations, but with under a year to go, she's restarting efforts, including getting physician buy-in.
"You have to get [all your physicians] on board," she said. "All of our doctors have different personalities and different learning styles … and we want to do right by them. We have good communication, a lot of meetings, and more so everybody gets on the same page."
Tiedeman outlined a five-point strategy her practice is using to achieve that goal with not only physicians, but everyone at the practice, from front-desk staff to coders. The first step is acknowledgement that yes, despite what happened this year in Congress, the shift to ICD-10 is going to happen. The sooner everyone understands that, the better.
"It's here and we're going full force with it," she said. "We have some physicians who are scared and others who couldn't care less. We have to make sure the scared aren't and those that don’t care get a reality check."
Next comes training — for physicians, "the sooner, the better" —and a diversified platform of offerings to meet everyone's preferences, said Tiedeman. The practice utilizes live seminars, webinars, "lunch and learns," and other methods to make sure not only the message is delivered, but the right message to the right specialty is delivered. With the number of codes expanding from about 13,000 to 68,000, it's critical that the hardest hit specialties get added education.
Communication is also essential, said Tiedeman, not just to physicians, but with staff and also your vendors. Both Tiedeman and Santalo offered questions that all practices should ask vendors (see sidebar below). And that tied to the importance of having the right software tools, both built into your existing EHR as well as add-ons that translate ICD-9 codes to their ICD-10 counterparts.
She also urged audience members to prepare for the transition now, especially financially. With denials expected to increase due to factors ranging from wrong ICD-10 codes to payers not prepared to accept them, Tiedeman stressed that practices "give themselves a financial buffer" for a short- or possibly long-term fiscal hit.
"We're getting a line of credit from our bank just to cover ourselves," she said. "We want to make sure we won't run into major cash flow issues. One of our practices might do great, but another might struggle, so we want to be prepared."
Santalo added medical practices "can't escape ICD-10," so it's best to be proactive and not reactive.
"It's already difficult to practice medicine with tons and tons of change," he said. "If [the transition to ICD-10] doesn't work out for your practice, it could be catastrophic in terms of revenue cycle failures. It could happen and if it does, it's a big problem."
Key Questions for Your Vendors
Are your practice management system and EHR vendors ready to support your practice in the ICD-10 transition? Here are some questions Santalo and Tiedeman advised asking immediately:
• Are you updating the software to comply with ICD-10 by Oct. 1, 2015? If so, how far in advance?
• When can we start testing?
• (To practice management system vendors) Will you offer dual-coding capabilities for claims so we can submit ICD-9 codes to entities not required to switch?
• Will we have to foot the bill for ICD-10 software upgrades? If so, how much?
• Will you provide us with training?
• How are the interfaces with other systems being handled?