March 18, 2014

End-To-End Testing Draws Questions, Not Volunteers, From Talk Ten Tuesdays Audience

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Eliciting more questions than volunteers, listener responses to yesterday’s edition of Talk-Ten Tuesday revealed that although providers are willing to participate in the Centers for Medicare & Medicaid Services (CMS) limited end-to-testing this coming July, uncertainty abounds.

 

During Tuesday’s broadcast, venerable healthcare authority Stanley Nachimson, once an official at CMS when the healthcare industry upgraded to 4010 on his watch (it since has been supplanted by 5010), described the recent CMS decision to conduct limited end-to-end testing. CMS, in its announcement — reported here last Tuesday on ICD10monitor — asked for volunteers who have until next Monday, March 24, to submit an application to their Medicare Administrative Contractor. (MAC).

 

Nachimson agreed to respond to individual questions submitted during the broadcast; a transcript appears below.

Donna:

We would like to participate in testing, but I did not get the survey.

Nachimson:

Application to volunteer is on the MAC websites.

Jennifer:

We are a hospital provider; if our clearinghouse is not selected, can we volunteer to submit claims directly to CMS?

Nachimson:

My understanding is that you have to be a direct submitter to Medicare to be selected for the testing, so you would not be selected. You may want to direct this question to your MAC.

Jennifer (not the previous respondent)

ZirMed is doing the testing for us, we understand.  

Is there anything specifically for physical therapy training?

That is, for outpatient physical therapy. Trying to find training for our providers. Upper management doesn't want to start training for a while.

Nachimson:

I am not aware of any training specifically for PT, but there are some training courses offered regarding orthopedics. You may want to look at those, or contact your local or national PT organizations.

JoAnne:

What percentage of providers submit claims through a clearinghouse?

Nachimson:

My understanding is that a large percentage do.

Jon:

Is CMS planning another test week again in May?

Nachimson:

I am not aware of any, but you may want to contact your MAC to see.

Karen:

Can a large healthcare organization with several divisions volunteer separately by division, or only one volunteer form per organization?

Nachimson:

You need to direct this question to your MAC.

Maria:

Will there be end-to-end testing with the IRF-PAI and CMGs for the inpatient rehab setting?

Nachimson:

The MACs will be selecting testing partners from the organizations that volunteer. They are attempting to select a variety of provider types. However, I do not know which organizations they will select.

Penny:

If you use a clearinghouse, is it true that you can't participate in end-to-end testing unless your clearinghouse does?

Nachimson:

That is my general understanding for this Medicare end-to-end testing period.

Susan:

Where can we access the application for the CMS end-to-end testing?

Nachimson:

On the MAC websites.

Tammi:

I applied to volunteer; however, I do submit my claims through a clearinghouse. According to what was mentioned, I’m assuming we will not be considered. Why are they only choosing a certain amount to volunteer? We have already successfully done front-end testing.

Nachimson:

They are limiting the number of testers due to resource limitations.

William:

Any testing with other payers’ crossover claims?

Nachimson:

I believe some testing is being done by the Medicare contractor that is handling crossovers. You would have to contact them directly.

About Nachimson

Stanley Nachimson is the principal of Nachimson Advisors LLC, a healthcare IT consulting firm. Stanley is focused on assisting healthcare providers, vendors, and plans with their ICD-10 and other regulatory implementations. He serves on the board of advisors for the Lott QA Group, a healthcare IT testing company. Stanley is the author of the recent authoritative paper on the cost of ICD-10 for physician practices — an update on his landmark study in 2008. Stanley is co-chairing the HIMSS ICD-10 Task Force and the WEDI ICD-10 Testing Workgroup. Stanley makes frequent appearances on Talk-Ten-Tuesday.

Chuck Buck

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