ICD-10 - Impact on the Revenue Cycle

Posted by Ecareindia on October 3rd, 2013

Right from Healthcare Providers to medical billing companies, everyone in the US is looking forward to one major change, which is the ICD-10 implementation. Though the transition of ICD-10 code sets will come into effect only by 1st October 2014, Healthcare Providers and Facilities and onshore and offshore medical billing companies have already started preparing for the change. There is no denial that this transition has numerous advantages like improving patient care, increasing physician billing accuracy, enhancing clinical performance and more. However, it is predicted that ICD-10 transition is sure to impact the healthcare revenue cycle management badly in the first few months of its implementation. Let’s discuss them in detail:

Extra Time Consumption: Consequent to the ICD-10 implementation, every Provider and medical billing company will be expected to update their coding system with at least 200,000 new codes. With the increase in the coding complexity, the time taken to code each chart will also increase. So, coders will find it hard to complete their coding processes within the intended time schedule.

Increased Coding Cost: The cost of coding per chart increases eventually, as the time taken to code increases. It directly impacts the healthcare revenue cycle management of Healthcare Providers and dependant onshore and offshore medical billing companies.

AR Pileup: It is predicted that Healthcare Providers and medical billing companies will face a lot more denials in the initial stages of ICD-10 implementation. The reason for this claim denial would undoubtedly be the increased complexity of codes and insufficient documentation, which trigger a lot of errors. The Payers will also be adapting to the new code sets and there could be Denials made in error.  Again, the revenue spent in cleaning up this accumulated AR will rise, affecting the normal cash flow.

Impact on Medical Billing Companies: The ICD-10 transition eventually increases the training and new technology costs of physician billing companies. This rise in cost impacts the outsourced Healthcare Providers and Facilities badly.    

Clinical Documentation Costs: The ICD-10 transition calls for new clinical documentation techniques, so physician billing staff will have a hard time getting adapted to them in the initial stage. Capturing clinical data as per the new techniques will definitely require some expertise for which training is necessary. Also, frequent audits are required to keep the documentation error-free. In both the cases, Providers and billing companies will be required to spend lots of money. Therefore, the overall healthcare revenue cycle management gets affected.   

Preparing for the ICD-10 transition in a full-fledged pace while administering physician billing functions will be hard for Providers as well as medical billing companies. Therefore, outsourcing a part of billing functions to a reputed offshore medical billing company like e-Care will be a good decision.

About e-Care India:

e-Care India is one of the renowned medical billing companies in India that promises the above mentioned benefits with total customer satisfaction. With 12 years of experience in the industry, e-Care’s 3 offshore medical billing delivery centers have been providing end-to-end medical billing services seamlessly to its clients. To know more about e-Care and its services, log on to http://www.ecareindia.com

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Joined: June 20th, 2011
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