Updated on: November 28, 2016

DEVELOPING: PMS Vendors Give Thumbs up on ICD-10 — So far

Original story posted on: October 4, 2015

Early reports from the first full day of ICD-10 indicate that some of the nation's practice management system (PMS) vendors are giving a thumbs up to implementation of the new coding set — although, of course, they're still waiting for the ultimate verdict: adjudication of claims. 

"Our experience is positive here at MedInformatix, from the electronic health record (EHR) perspective," Chris Bruns told ICD10monitor in an email. "Our customers that prepared well are already providing positive feedback."


Bruns, who is the product manager for MedInformatix a prominent PMS vendor, said his company was spending most of its time providing training to sites that were underprepared, or those that had just recently updated their software.

"Of course, in terms of assessing the transition, we're most interested in seeing adjudicated claims and denials to make an informed determination," cautioned Bruns, also the president of the Healthcare Administrative Technical Association (HATA). "That's a day or two out, at minimum."

Other HATA members were reporting similar experiences on Thursday, the first the day of ICD-10 compliance for covered HIPAA entities. Here is sampling of responses:

"So far it's a non-event for both our application and our clearinghouse," said Ana Croxton, senior vice president of EDI products and services for NexGen Healthcare. "We've had more calls, but nothing earth-shattering. But it's early yet. I am hoping it continues."

"Much the same for us. Some increased call volume and of course a huge spike in the use of the online ICD-10 coding tools we have, which allow us to monitor activity," said Patrick Hall, executive vice president for e-MD. "The existing calls appear to be from those customers who have been less engaged with the resources we've provided for several years, but we expected that and have our support teams amped up on donuts and coffee. Our revenue cycle management (RCM) operation is seeing claims get past front-end edits without problems and are now monitoring for payer responses."

"Call spikes due to training and lack of preparation (asking for help with charge slips has been big, especially for those switching from paper)," noted Jill Finn, manager of program management for AdvancedMD. "Like everyone else, we're just waiting to see what happens with the adjudication."

"Pretty quiet here as well; (there are) a few EMR (electronic medical record) partners who had not finished their updates to the interface into our PM system, resulting in some charge import errors," reported Eric Christ, executive officer for PracticeAdmin. "In 24 hours, we'll see if claims make it through the clearinghouse to the payers. Then a day or so more to see if payers accept them for adjudication."

HATA is the nonprofit trade association representing the PMS industry and other affiliated stakeholders. HATA reports that its members represent over 300,000 medical providers that use software to submit insurance claims for their practices. The industry represents nearly 100 percent of all initial claims submitted on behalf of hospitals, physicians, and allied healthcare professionals.

In a related development, the Centers for Medicare & Medicaid Services (CMS) circulated a blog posting from its deputy administrator and director of the Center for Medicare, Sean Cavanaugh.

In his midday posting, Sean wrote that it will take a couple of weeks before CMS has "the full picture of ICD-10 implementation, because very few healthcare providers file claims on the same day a medical service is given."

Cavanaugh said it would take several days for claims to be processed, and "Medicare – by law – must wait two weeks before issuing payment. Medicaid claims can take up to 30 days to be submitted and processed by states."

In his blog, Cavanaugh said CMS would be monitoring the transition in real time while watching their systems and addressing any issues that come to the ICD-10 Coordination Center.

"The Coordination Center is a dedicated group of Medicare, Medicaid, billing, coding, and information technology systems experts drawn from across CMS," wrote Cavanaugh. "They have the full support of the entire CMS staff to address any issues quickly and completely."

Reminiscent of the cartoon in which two bankers are seen plunging from their skyscraper offices while saying to themselves, "so far, so good," the story of the nation's adoption of ICD-10 remains to be written.

But again: so far, so good.


Chuck Buck

Chuck Buck is the publisher of ICD10monitor and is the executive producer and program host of Talk Ten Tuesdays.

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