ICD-10—We are in this together

Dane Laverty, Eyefinity.com Product Manager

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You’ve heard about the changes to expect when the industry transitions to ICD-10. You know that practices will be impacted, and must plan and prepare, but have you considered what needs to happen on the other end to keep the claims process moving?

Solution providers, clearinghouses, insurers, and CMS all must be prepared for ICD-10 before October 1, 2015 to accommodate services and claims when it begins. From every angle, the change to ICD-10 is a really big deal.

I’ve been working hard to ensure Eyefinity.com is prepared to handle the cutover to ICD-10 on October 1. Our team is wrapping up development and it’s come together really well. But what does this mean to you? According to the law, all payers must accept and process claims using only ICD-10 codes on October 1. It’s a hard and fast rule and date, with no exceptions.

You’ve probably used Eyefinity’s eClaim to submit claims to VSP. But did you know that you can use eClaim to submit claims to over a thousand other payers?

Eyefinity.com handles millions of claims each year, every one of which contains diagnosis codes. Suffice to say, the effort to coordinate changes in our systems while monitoring the status of all of the payers that eClaim submits to has kept me up at night, ensuring that it works efficiently and without problems. Eyefinity, VSP, and our partners have worked closely to ensure a seamless transition from ICD-9 to ICD-10, so that on October 1 Eyefinity will be ready to support you.

We’re taking a proactive approach to be sure that we’ll be ready for the change in plenty of time. Will you be ready, too? It may not be easy, but the key to success is taking the time to research and learn now.

What does 2015 hold for meaningful use?

Since the meaningful use program began, there has been an abundance of challenges to successfully demonstrate and attest.  According to CMS, only 4% of eligible professionals (EPs) have successfully attested to Stage 2, and beginning this month, 257,000 EPs will be assessed penalties as a result.

Progressively Tougher RequirementsPROOF_19922DR_fixit_blog
As the program currently stands, beginning this year, the meaningful use demonstration period is required to run for the full 365 days of the year, rather than 90 days as required in previous years. In an effort to mitigate the additional challenge and facilitate successful attestation, Representative Renee Ellmers introduced the Flexibility in Health IT Reporting Act (Flex-It) in 2014.

If passed, Flex-It will reduce the demonstration period in 2015 to 90 days, rather than the full year that is currently required for those attesting for either Stage 1 or Stage 2. Those in their first year of Stage 1 will attest to a three month period regardless of the outcome of the rule. In 2015, EHR solutions must be 2014 certified to qualify for meaningful use attestation.

Though the act was submitted, no decision was made in 2014. Not to be dissuaded, Rep. Ellmers has reintroduced the bill in January, and has the backing of legislators from both the Democrat and Republican parties.  Stay tuned, we’ll keep you posted on the status of the Flex-It Act, when its fate is decided, and all of the latest news on meaningful use.

Do you have questions about meaningful use? We’re here to help! Contact us at meaningfuluse@eyefinity.com.

ICD-10—Coming Soon to YOUR Practice

Michael_OpsteeghBy Michael Opsteegh, Sr. Technical Writer

Were you one of the many providers waiting to see if the ICD-10 compliance date would be postponed beyond 2015? Despite mounting efforts to delay ICD-10, members of Congress refused to include the delay in the “Cromnibus” bill passed in December. Failing to slip the delay into a massive spending bill may prove to be a fatal blow to the delay effort. ICD-10 will be required beginning October 1, 2015. Are you prepared?

For all of the hype around “the big change,” you may be surprised and pleased to find how easy it can be to manage—if you’ve prepared properly.

Preparation is Key
So, how does a busy provider prepare for such a change? Transitioning to ICD-10 can have a huge impact on reimbursements in the form of rejections for incorrect coding or additional time needed to properly code. Take heart—your experience doesn’t have to negative. Simply prepare.  Employ tools, like Eyefinity EHR or ExamWRITER, that will manage the conversion and coding for you. Our EHR products will take on the coding, step you through code selection, manage the transition from ICD-9 to ICD-10 based on service date.  If you want to see when your EHR will be ready, check out our ICD-10 resource page.

With preparation in mind, CMS has identified testing periods in 2015 to ensure that submitting claims using ICD-10 codes will be successful for providers, clearinghouses, and payers. Test groups for each period are limited, and applications must be submitted to be selected to participate. For more information, check out the CMS MLN Matters publication.

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New Year’s Resolution: Understand the Impact ICD-10 has on Your Practice Financials

Cristin_Hollis_webBy Cristin Hollis, Revenue Cycle Management Supervisor

With the New Year comes the realization that ICD-10 is only 10 months away. AHH! Did anyone else’s anxiety just spike? Have no fear! There is still time to plan and prepare for the change. My particular interest is on how ICD-10 may impact your practice financials.

Most change brings associated costs and ICD-10 is no different. You may have already factored in software conversions, training, coding education, and clearinghouse fees, but ICD-10 also has the potential to impact areas you may not have considered.

Here are some questions to think about:

  • How will ICD-10 impact your practice revenue?
  • How will ICD-10 affect your cash flow?
  • Will you need more staff to maintain your current day-to-day operations?

These are difficult questions and even more difficult to answer if you’re dependent on third parties during the transition. Still, you can take steps to prepare yourself for October 1.

Where to Begin
Your first step should be to leverage your current ICD-9 workflow and analyze your historical practice data. Knowing your historical claim volumes, reimbursements, and payer mix will give you a good indication of the impact to expect as a result of the transition to ICD-10.

What areas may be potentially affected?

  • Accounts receivable cycle
  • Cash flow
  • Provider reimbursements
  • Claims submissions
  • Payer processing turnaround

Prepare for delays or adjusted cash flow now to avoid hardships in October. And finally, make sure all doctors and staff are prepared. With proper preparation, additional staff and resources may not be necessary at all.

Do you have an ICD-10 question or topic on your mind? Let us know.

ICD-10: Change is the One Thing No One Can Avoid

By Marsha Vaughn

Sr. Eyefinity Education Consultantpix

Change is the one no one can avoid. In fact, the only thing you can be sure won’t change is “that things will change”.

How you manage that change to benefit your practice is up to you. Let’s look at how you can handle up-coming ICD-10 code changes.

First order of action is to understand why the change is happening.

With ICD-9 we are running out of codes to effectively communicate patient diagnoses and care. ICD-9 was first implemented more than 30 years ago – I was carrying a bag phone then and the cost of gas was about a buck.

Today, many strides have been made to improve the care, reporting, and sharing of health data through technology. The transition to ICD-10 is the next step. Instead of general codes with lengthy explanations, there will be specific definition in the used code itself. You may be asking will this really simplify things or only make it more complicated as new technology being used for the first time often does? There’s good news, you won’t be the first one trying it. Other countries went to ICD-10 coding years ago, thus it’s an international standard that has been tried, tested, and is actively in use.

Still, change management is challenging.

It is a big change for everyone who diagnoses and bills from the large hospitals to the one doctor towns and specialized practices, such as eyecare. Some of these businesses will suffer if payments were delayed.  And it is a big change for all of the software developers and insurance companies. But, as a patient, as a parent, and as a child of aging parents, I don’t want anyone’s health care compromised, medical coding confused, or billing delayed. Which means I’m committed to making this change a success.

 Sure, ICD-10 is a government mandated change, but I prefer to look on the bright side.

As an employee of VSP Global, Software Division, I work hard with my team to develop the underpinnings of coding and billing. Luckily, we’ve already had a jump on ICD-10, when the year delay was announced. This additional year to prepare makes me certain that the entire medical and insurance communities are at high levels of development and readiness.

Furthermore and specific to our industry, an internal analyst told me that the top ten codes billed through VSP claims comprised 91% of all vision claims and nine out of ten of those ICD-9 codes have a one-to-one match with an ICD-10 code. This means the new codes we will have to learn might not be as difficult as some people make it out to be. How long did it take us to get the ICD-9 codes stuck in our heads? Once the change is made, we will do the same with ICD-10.

Check back with us weekly for more ICD-10 stories from the front line.

Eyefinity EHR and ICD-10

By Phernell Walker, II, BSB, ABOM IMG_3522

Sr. Eyefinity EHR Product Manager

Master in Ophthalmic Optics

 At this very moment I’m typing from an airplane at 35,000 feet above the ground, on my way to visit another client to discuss the monumental change headed our way in just a matter of months, ICD-10.

As the Sr. Product Manager for Eyefinity EHR, I believe the best way to know and understand the pulse of my clients is to work with them up close and personal.  Therefore, much of my time is spent on the road traveling to work with optometrists across the entire country. One thing I’ve recently found is that hundreds of optometrists are expressing their concern about ICD-10. Hearing this feedback led me to conclude that in order to meet my clients needs, Eyefinity EHR would not only have to include a feature that supported ICD-10, but that it also needed a feature that handled it seamlessly in effort to lessen complications for my clients.

So, you might be thinking what I have done to liberate optometrists concerns about ICD-10?

  • Eyefinity’s engineering team took all of the ICD-10 Codes and built them into Eyefinity EHR.
  • We use a complex algorithm that automatically takes the exam information doctors have documented in Eyefinity EHR and then correctly calculates the correct ICD-10 Code for them.
  • Not only does Eyefinity EHR render the correct ICD-10 Code, it also allows optometrists to view the corresponding cross-mapped ICD-9 code in real time next to the ICD-10 Code.

Optometrists can rest assured that Eyefinity EHR makes the transition to ICD-10 hassle and worry free. I know because I see the results in the practices I visit. I see Optometrists who have benefitted from Eyefinity EHR and now use their time and attention to meet their patient’s needs.

You can get a free one-on-one demo of Eyefinity EHR by visiting http://www.eyefinity.com/ehr-efficiency.

ICD-10 Basics

IMG_3522By Phernell Walker, II, BSB, ABOM

Sr. Eyefinity EHR Product Manager

Master in Ophthalmic Optics

ICD-10 is scheduled to replace ICD-9 on October 01, 2015. This affects every health care provider in the entire country, not just Eye Care Professionals (ECPS’s). Think of the significance of expanding the Diagnosis Code count from 14,000 plus codes to a staggering approximate 71,000 plus codes and growing.  That’s definitely a monumental change.  A great example of this exponential change is a basic singular diagnosis code such as myopia, is now expanded to 5 codes.

 

Example:

 

ICD-9 ICD-10
367.1 Myopia H52.11 Myopia, right eyeH52.12 Myopia, left eye

H52.13 Myopia, bilateral

H52.10 Myopia, unspecified eye

 

365.11 Primary Open

Angle Glaucoma

H40.11X0 POAG. Stage unspecified

H40.11X1 POAG, mild stage

H40.11X2 POAG, moderate stage

H40.11X3 POAG, severe stage

H40.11X4 POAG, indeterminate stage

 

 

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