Updated on: November 28, 2016

Cooperative Exchange Declares ICD-10 Implementation “Non-Event”

By Mark Spivey
Original story posted on: December 17, 2015

The organization representing the healthcare clearinghouse industry has declared the much-anticipated implementation of ICD-10 a “non-event,” according to a statement issued this week.

The assessment was based on the Cooperative Exchange’s view that “good ICD-10 planning, education, testing, and industry collaboration” resulted in a smooth transition for most healthcare providers nationwide.

 

“Overall, the majority of the industry has transitioned with minimal material impact to date. We are very pleased with the smooth transition experienced going into ICD-10, as well as post-ICD-10 production results for our business, but more importantly, for our clients,” the statement read. “Claims are moving, payers are accepting, and rejections are very low in general – and in line with our everyday metrics created before ICD-10. When the industry works together with the right approach and does things the right way, the results are good!”

Immediately after ICD-10 implementation, the Cooperative Exchange assembled a work group that met weekly with the objective of sharing experiences and trends regarding the new coding set, as well as identifying top issues, establishing metrics, and communicating about challenges being encountered.

That resulted in some “minor issues” being identified, but all of them were quickly resolved, the organization reported.

“There was a feeling of accomplishment, knowing that the industry had worked together and actually had a smooth implementation and transition. As we approach a new year, we need to ask, ‘what do we need to do going forward to continue and ensure success?’” Cooperative Exchange’s statement continued. “In that spirit, we asked some of our ICD-10 work group members how they plan to support providers with their ICD-10 implementation during 2016. What should providers look forward to from their clearinghouses?” 

Responses varied, but no one seemed to suggest that something currently considered a “non-event” wasn’t at least worth monitoring closely during the next year, with an eye on making continual adjustments. 

“Looking ahead to 2016, Change Healthcare (formerly Emdeon) will focus our ICD-10 innovations on areas that enable smarter healthcare. We will continue to monitor ICD-10-related rejections, denials, and underpayments to help our customers understand the impact to their revenue,” said Deb Meisner, vice president of regulatory compliance for Change Healthcare. “We will leverage our analytic capabilities to provide deep insight into trends that empower clients to better manage their revenue cycles. Development of new consumer payment tools will draw upon the strength and depth of the Intelligent Health Network™.”

“SSI remains focused on ICD-10 for the transaction sets directly affected by this implementation. In 2016, we will continue to analyze our business regarding rejections, denials, and reimbursements for our customer base to determine what impacts are directly related to ICD-10,” added Joan Kossow, data compliance manager for the SSI Group. “SSI will continue to work with the payer community as needed to ensure continued success. We anticipate business as usual in accordance with current trends as variances identified thus far can be attributed to normal business set forth by our benchmarks.”

“As the dust settles from the initial months of ICD-10, and as the financial impact for providers becomes more measurable and better understood, ZirMed will continue to empower its clients to extract value from the newfound granularity and complexity of the ICD-10 code set. The critical ICD-10 metrics we’ve helped providers identify, those that really determine long-term financial sustainability and operational efficiency, will remain at the core of that effort,” said Crystal Ewing, senior business analyst and manager off regulatory strategy for ZirMed. “As we uncover and model new or shifting payer-specific patterns and behaviors, we will further refine our solutions to maximize workflow productivity and financial benefit for our clients. 2016 is the critical learning period for everyone in healthcare – it’s when we as an industry can begin to bring additional evidence-based forces to bear on optimizing for ICD-10.”

In looking ahead for 2016, Jopari Solutions said it would continue to benchmark ICD-10 results and provide ongoing customer educational outreach efforts and resource tools for process improvement. “We have not seen any significant post ICD-10 implementation impact to date and do not anticipate any trend changes in 2016,” said Jopari’s Sherry Wilson, executive vice president and chief compliance officer. “We will continue to refine our analytic tools and services for our customers in 2016 to increase first time clean claim submission, improve revenue cycle management and enhance end to end workflow automation between providers and payers.”

In summary, the Cooperative Exchange reported, providers should look for continuous support from their clearinghouses in the areas of education, analytics, KPI reporting, and tools to assist them in improving their revenue cycle management. Providers can obtain additional information on the Cooperative Exchange and can access the ICD-10 Monthly Benchmark Metrics at www.cooperativeexchange.org.

“Clearinghouses are committed to the continued success of ICD-10 and the overall valued return for our efforts to get there,” the organization concluded. “Providers need to measure and manage reimbursement analytics that will indicate revenue challenges ahead, taking advantage of the tools and services provided by their clearinghouses.”

 

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.

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