End of ICD-10 Grace Period: What the Data Reveals
We’re well into the new year, and roughly five months into the post-ICD-10 grace period. While data is still rolling in, what is the data revealing with respect to claims so far?
Overall, things are going very well. Providers appear to be getting paid faster, with fewer denials, and are realizing lower processing time.
Total claims processing time appears to be cut in half from pre-ICD-10 days, with total processing time of 26 days as of the end of Q4 2016, down from 45 days in Q4 2014 (pre-ICD-10) and 44 days during Q4 2015, which was in the midst of ICD-10.
Providers also appear to be getting paid faster than before ICD-10 went into effect, with nearly 74 percent of claims being paid within 30 days (up from 65.5 percent pre-ICD-10, and 62 percent immediately following ICD-10 implementation).
Denied claims are down just slightly, from 15.4 percent pre-ICD-10 to 13.8 percent post-grace period.
And while our stats are likely to continue to change over the coming months as claims continue to roll in, one could probably conclude that the healthcare industry took ICD-10 preparation to heart and were well prepared to accommodate the thousands of new codes resulting from ICD-10.
We will continue to keep you apprised as new data rolls in.
Healthcare IT: A Constant Among Uncertainty
The idea of change within the healthcare industry is nothing new. We’re used to change, but that doesn’t make it any easier to adapt. In the past few years, we’ve seen many initiatives invoke change in healthcare, particularly in administration and revenue cycle management – from the Affordable Care Act (ACA) and the need for alternative payment models to ICD-10 and MACRA. As we launch into 2017, even more change and uncertainty are upon us with the repeal of the ACA.
Despite the change and uncertainty, there is a constant you can turn to in this digital age: Information Technology (IT). Thanks to incredible innovation and advances made in healthcare IT, data and analytics, we have been able to adapt to change and break the barriers of uncertainty.
So, how can we look at something like IT and data analytics as the constant among these waves of change? The first trick is to remember that technology and data are simply tools to help us, not hinder. The second trick is to find a solution that will enable you to use these tools to your advantage.
That’s where we (RemitDATA) come in.
So, as you head to HIMSS 2017, embrace all the advances in technology. They were built with your business (and your customers’) needs in mind.
In RemitDATA’s case, our goal is to show you:
- How simple it can be to leverage data (your own or your clients’) to help accelerate business growth in spite of any changes that may come.
- How comparative data solutions could be an additional revenue stream for your sales channels
- How comparative data solutions can help to win more business and strengthen your customer relationships
Let us show you.
The best way to understand how comparative data can help improve the revenue cycle process and help improve your or your customers’ bottom line is to visit us at HIMSS 2017 in Orlando, Florida at Booth #5847.
In a matter of minutes, you will witness what comparative data analytics solutions can do!
If you’re anxious to learn more now, you can get a quick preview of what we can do by viewing one of these short use cases for payers, providers and billing companies in our Knowledge Center.
Also, be sure to check out our Compare Your Data page! See denial rates by specialty in your state and how they compare to the industry average! How do you compare?
See you in Florida!
See How You Compare and Win at Medtrade 2017!
We’re gearing up for Medtrade 2017! We have been following trends around the DME and Medical supply market to stay on top of what is important to YOU.
Lately, it seems more difficult than ever before to stay in control of your bottom line and maintain transparency between organizations. Competition in this market (as you know) is fierce. To stay ahead of the game, the trick is to understand your metrics and how they measure up against your peers/competition.
Quick example: Did you know the national claim denial rate for the DME and Medical Supply market decreased from 17.47% to 16.91%. If your business’ claim denial average was higher than the national average, it would likely raise some red flags? Do you have solutions to help you quickly take action?
That is what the power of comparative data analytics can do for you. With this kind of insight you can:
- Set benchmarks for success
- Apply intelligent actions to achieve your business goals
- Ensure customer satisfaction
- Stay ahead of the competition
The steps to gain this knowledge is simple, and it starts with one very easy and encouraging step. First, check out how you compare so you can begin the process to identify inefficiency gaps in administration and revenue cycle management.
Next, when you get to Medtrade Spring 2017, come by the RemitDATA booth #832 and we will show you how you can compare, and begin to drive your business forward.
Just for stopping by, you will receive a $10 Poker Chip that can be used at the Mandalay Bay Casino (while supplies last), and be entered in for a chance to win a $100 Amex Gift Card.
If you are ready for more now, please contact us today to speak with a RemitDATA solutions expert and get ready for a very successful year!
MACRA is Coming: Tips to Prepare
Are you ready for MACRA? If not, you’re not alone. A recent Deloitte Center for Health Solutions 2016 Survey of U.S. Physicians states that 50 percent of physicians surveyed have never heard of the law, and 32 percent recognize it by name but are not familiar with its requirements.
Alarming? Yes. But it’s not too late to prepare.
For those who do not know about MACRA: it is the Centers for Medicare & Medicaid Services (CMS) Medicare Access and CHIP Reauthorization Act of 2015. MACRA is a Medicare payment law intended to drive healthcare payment and delivery system reform for clinicians, health systems, Medicare, and other government and commercial payers. MACRA is intended to create a path toward a new Medicare payment system that will more closely align payment with quality and outcomes. It offers financial incentives for healthcare professionals to participate in risk-bearing, coordinated care models and moves away from the traditional fee-for-service system. Providers participating under the Medicare fee schedule will generally choose between participating in Alternative Payment Models (APMs) or receiving payment based on individual performance under the Merit-Based Incentive Payment System (MIPS).
It’s not too late to get informed on all things MACRA, as there are tools and resources available. The American Medical Association recently introduced a series of online tools designed to help providers transition to Medicare’s new payment schemes under MACRA. In the AMA’s STEPS Forward platform there are 42 modules, including those on selecting and implementing an EHR, reporting to data registries, and complying with the law’s quality measures. The AMA also released a Payment Model Evaluator, which will help providers understand how MACRA will affect them and how best to succeed under the new law.
Bottom line: Staying apprised of all-things MACRA, taking advantage of tools, data and other information will help as you prepare your practice for this change.
Read more in Becker’s Hospital Review.
Happy Holidaze: Be Sure Your ICD-10 Code Book is Close By
Season’s greetings to all! As we enter the busy holiday season, you are sure to begin seeing an uptick in patient visits.
You may want to be on the lookout for the following ailments:
As you close out the books to a successful, though likely challenging 2016 due to ICD-10, we’d like to offer a
happy holiday greeting to all, and best wishes for a prosperous 2017!
Healthcare Consumerism is Shaping Payer/Provider Relationships
Consumers today have it easier than ever before. In this digital age, information is as accessible as the air we breathe. There are apps that help us compare mortgage loans, the cost of a car, even groceries.
Consumers are savvy and are rightfully seeking pricing information from providers – before a service is performed. It’s only natural.
However, the healthcare industry has some obstacles to overcome to achieve this level of transparency, even with the mandates of the Affordable Care Act (ACA). Let’s sum it up with a few quick facts from Public Agenda’s 2015 Report. Did you know:
- Most Americans are not aware that prices can fluctuate across healthcare providers. 57 percent of insured and 47 percent of uninsured Americans are not aware that physicians might charge different prices for the same services.*
- 67 percent of those with deductibles between $500 and $3,000, and 74 percent with deductibles higher than $3,000 have sought out price information before getting care.
Despite the obstacles, there is hope.
- 82 percent of those who have compared prices across multiple providers say they will do so again in the future.
The demand for medical cost transparency has led to many alternative payment models (like bundled payments), which are proving extremely beneficial. This “82 percent” stat tells us comparative data analytics work and are increasing transparency and collaboration of medical costs like never before.
These types of changes will ultimately help bottom lines across the industry – making it easier for the patient to make wise budget decisions. Over time, providers would see less payment defaults and payers could monitor and further reduce costs.
So, healthcare industry, what can we do to keep up?
Read the article published by AdvanceWeb to learn more.