Will ICD-10 Medical Coding increase AR & Denials?

Posted by Deepak Sanghi on October 30th, 2015

It has been only three weeks since the ICD-10 medical coding implementation, but the impacts of the new code setup have already created a lot of concern for US Medical Billing companies. Although, the CMS’s concession policy sounds relieving and promising, handling AR and Denials could become a herculean task for these Billing companies. Amidst various activities like training the staff on the complex ICD-10 medical coding set and monitoring the medical billing AR follow-up and denial management processes, Billing companies can hardly find time to offer quality customer care services to their end customers. The ideal solution to face all these challenges would be to work with offshore medical billing companies. Let us now discuss the present scenario:

Before ICD-10 Medical Coding Implementation: During this phase, US medical billing companies followed stringent denial management and medical billing AR follow-up measures to keep the inflating AR under control. Since they were familiar with the ICD-9 code set (which has been in use for decades), medical billing and coding was quite simple. In addition, finding the commonly made coding errors was also easy. Despite the various changes in healthcare introduced by Obamacare, US Medical Billing companies balanced them by outsourcing to offshore based service providers.

After ICD-10 Medical Coding Implementation: After a three year delay, the transition from ICD-9 to ICD-10 medical coding set happened on October 1st 2015. Due to the inclusion of over 200,000 codes to the current nomenclature, Healthcare Entities are finding it difficult to adapt to the new method of Coding. Therefore, the coding error rate is bound to spike up resulting in claim denials. Managing this potential AR pile-up would be impossible for Healthcare Entities while overseeing customer care, adding new customers and other functions.

CMS Concession Policy: One relief about the ICD-10 medical coding implementation would be the CMS’s concession policy. According to this policy, Healthcare Entities will still get paid for one year on claims coded within the same group of codes and not very specific. In the meantime, US medical billing companies are expected to learn the nuances of coding using the new ICD-10 medical coding set.

What can be done?

It is a great thing that CMS has come with a concession policy to allow Healthcare Entities learn from their mistakes. However, the 1-year time period must be properly utilized. While they get accustomed to the ICD-10 medical coding set, offshore medical billing companies can provide a lending hand to take care of the medical billing AR follow-up and denial management processes. Looking for a reputed and a highly-experienced offshore medical billing company? Consider partnering with e-care!

About e-care India:
e-care India has 15 years’ of experience in the industry. e-care’s 3 offshore medical billing delivery centers have been providing end-to-end medical billing AR follow-up and denial management services seamlessly to its clients. To know more about e-care and its services, log on to www.ecareindia.com.

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Deepak Sanghi

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Deepak Sanghi
Joined: August 31st, 2015
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