If your organization reflects what our data is revealing, the past 12 months have likely been relatively uneventful. Taking a look at our data, we are continuing to see a steady decrease in claims processing and payment velocity. Reviewing average processing time from October 2015 through September 2016, we are noting that processing time is down.
And yet, by the time you read this blog, we’ll be well into October, the grace period for getting the correct code will have ended. As you are likely aware, the Centers for Medicare and Medicaid Services (CMS) stated that it will not extend the ICD-10 grace period beyond October 1, announcement released in August. When ICD-10 went live in 2015, CMS said it would not deny claims as long as healthcare providers used codes in the correct “family” related to the treatment. This is now changing.
Claim denials, already one of the largest areas of lost revenue for healthcare organizations, have even greater potential to impact the bottom line as the grace period ends.
In order to minimize the impact, be sure to benchmark your performance and implement a denials management process, to identify any coding discrepancies or process road blocks.
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