ICD-10 Redux | Questions & Answers
As your practice is preparing for the impending ICD-10 changes, you might have many questions concerning billing procedures and software requirements. To help you get the answers you need, we have compiled some common questions and answers. Feel free to add any new questions in the comment section below. Q: I have a question about the top 50 ICD-9 codes we use, and doing the crosswalk to ICD-10. Where is the best resource for being able to do that? A: CMS GEMS would be one website that you can use; that’s CMS’s GEMS System, which is the General Equivalent System that they use — the General Equivalent Mapping System that they use to translate ICD-9 to ICD-10. Another good site for you is AAPC.com. Click on their ICD-10 link and they have a feature where you type in our ICD-9 and it returns the equivalent ICD-10 code. GEMS prompts you to choose the lateralities and origins, whereas AAPC is more one-to-one, but GEMS is really what most systems are basing their crosswalk from, and GEMS is built and maintained by CMS, the CDC, and AMA. Q: I’ve done all my conversions from ICD-9 to ICD-10 and I’ve done the left and right conversions. We’ve changed some of our documentation so it’s more specific about mechanism of injury — the when, where, the why and the how. What else is there really to do? A: You really want to make sure that how the practice is supposed to document the guidelines for documentation are clearly outlined in your policies and procedures manual. And that means adding in specificity and laterality. The manual should also have references as to where you seek the information; your reference point would be to CMS. Q: If I want to take a coding course to get certified, do I need to be certified on ICD-9 and ICD-10? A: Right now, you have to certify for both, but after October 1, 2015, you only have to certify for ICD-10. Q: Are you able to come out and help us train our staff? A: We can give you the tools that you need in order to train your practice. They can also take external classes — specifically from the AAPC, because their classes on physician documentation are extraordinary. In terms of crosswalking, we will work with you. Q: Where can I find CMS guidelines in written form? A: On CMS.gov, click on the Medicare link and you will find a link for both local and national coverage determinations. Q: When can I start finding ICD-10 codes within your software and submitting them? A: Our software already has all of the ICD-10 codes listed; we are building the crosswalk now. We recently completed ICD-10 testing with Medicare, and were successful with our front-end edits. We are looking to have this available to practices by June, to really start testing and crosswalking. At this point, payers are not accepting claims in ICD-10; they are not coming over until October 1, 2015, but we are testing with payers and clearinghouses directly. Q: Will you install products well before the October 1, 2015, deadline, so I can begin testing them now? A: We began crosswalking for ICD-10 in February 2014 and completed the process in April. Speak with your coach about testing for the new coding system. Q: When will you update my current products and applications for ICD-10? A: Our products are continuously update in accordance with new regulations and policies, so the ICD-10 changeover will be virtually seamless. Q: Will there be a charge for these updates? A: We do not charge for updates. Q: Will I need new hardware to accommodate ICD-10-related software changes? A: No. Our software, being cloud-based, will continue to run on your current hardware. Q: What are the costs associated with maintaining new products? A: There are no additional costs.
SWAT outsmarts payers to resolve billing issues
Beating the insurance companies at their own game can be extremely frustrating and time-consuming for chiropractors who want to improve the cash flow at their clinics. Even when a provider makes time to deal with the payers instead of treating his patients, he usually lacks the necessary expertise to resolve any issues and often ends up losing massive amounts of profit due to delayed, denied or reduced payments for submitted claims. So, when the going gets tough and a provider finds himself overwhelmed by complex billing issues that keep him from getting paid, Genesis’ SWAT (SPOCs With Attitude and Training) Team steps in to save the day and discover underpayment and delay tactics in massive volumes at the request of the provider’s account manager (a.k.a. SPOC). By analyzing large amounts of data to discover trends for underpayments and delay tactics SWAT puts the combined expertise of over 50 years of billing, practice management, and Vericle experience to use to come up with creative solutions to counteract the payers’ tricks and outsmart them. These solutions are then shared and implemented as concerted effort by multi-specialty teams, including practice managers, billers, account managers, audit and quality assurance managers, systems development, customer support, and the technology team who focus on large-scale problems. The SWAT team is not geographically limited in any way and works effectively to solve chiropractic cash flow issues across multiple states and specialties regardless of any differences. As case in point, SWAT helped a practice collect $5,418 in payments after months of not receiving any money for submitted claims in spite of being re-credentialed as group provider by Medicare. The solution consisted of correcting an incorrectly entered provider’s Group NPI number so that the practice can now enjoy steady income from Medicare. In another example, SWAT helped a practice increase their income from $600 to $15,147 by discovering and correcting inaccurate data that had led to denied claims. These corrections also resulted in steady income from Medicaid and significantly increased profits. Ultimately, Genesis’ billing SWAT team will go to bat for the practice owners against any and all payers who try to avoid paying what they owe for claims.
Compliant Care Plans with Cash Practice
Did you know Billing Precision has integrated with Cash Practice? What does this mean to you? It means with the Cash Plan Calculator® System you can create 100% customized care plans for individuals, family plans and plans with insurance! Having customized, professional, affordable and complaint care plans is the key ingredient to patient retention. What You Need to Know About Care Plans By Cash Practice: Are you giving any of your practice members discounts on their plans? Are you confident the care plan is legal? Are you relying on what your friend down the street is doing? Most Chiropractors are creating care plans in a NON-COMPLIANT fashion which puts their practice and it’s members in jeopardy. We’ve teamed up with some of the industry’s noted experts in the field of compliance and discounting to ensure our Cash Plan Calculator® is providing Chiropractic offices with a trustworthy source for financial plans. Don’t gamble on what you think is right – join Cash Practice today and gain piece of mind! Having clients commit to an outlined program of care, with affordable financial options has many benefits: Better compliance on following care plan recommendations. Clients easily transition on the the next phase of care. Increased collections. Decreased dependence on insurance money. More time to focus on patient education, marketing, etc. Consistent cash flow coming into the practice. Client retention!! Imagine a Practice Full of Clients who Pay, Stay & Refer! Become a member of Cash Practice® today! Yours in health, Billing Precision & Cash Practice®