Updated on: November 21, 2016

Practice Management Systems Ready to Test with Clients

By Jill Finn
Original story posted on: August 10, 2015

Recently, the Healthcare Administrative Technology Association (HATA), the national association for the practice management system (PMS) industry, released the results from a survey on PMS vendors’ ICD-10 readiness as of July 1, 2015.

Results indicate that of the PMS vendors who responded, 75 percent were finished with their internal preparations (impact analysis, resources allocated, development strategy, testing strategy, deployment strategy, communication plan, internal testing plan, client training plan, system developed, system tested, system changes deployed, plan communicated to customers). Two-thirds of respondents had trained their customers, 60 percent already had tested with clearinghouses/carriers, and half had tested with their customers. Forty percent of the PMS vendors that responded had completed end-to-end testing with a quarter of their clients, and 40 percent had completed end-to-end testing with 75 percent of their clients.

PMS vendors play a vital role in states that haven’t adopted ICD-10 for P&C claims. PMS vendors that responded to the survey indicated that all of their systems currently allow for dual coding and that they plan to allow for dual coding after Oct. 1, 2015. The rules governing this are currently unclear, so 80 percent will continue with no time limit, while 20 percent have capped their dual coding at six months.

PMS vendors that responded also are 75-100 percent complete in the deployment of their development strategy and testing strategy products and services, and 60 percent indicated that these are already available to their customers. All of the respondents indicated that their ICD-10 services and software are available to customers, that their development strategy and testing strategy are completed, that their PMS changes for ICD-10 are finished, and that they have begun to do External Testing. All respondents also expect to be able to utilize ICD-10 codes on the current federal compliance date of Oct. 1, 2015.

“What this survey tells us is that contrary to the notion that the holdup with ICD-10 testing lies with the PMS vendors … an overwhelming majority of practice management vendors are ready and testing with clients and the payors,” HATA President Chris Bruns said.

However, there is still a concern among MGMA and others regarding a large block of providers that are still submitting 4010 claims, which is not an acceptable format for ICD-10.  The Cooperative Exchange, the association representing the clearinghouse industry, recently conducted a survey and found that clearinghouses receive 12 percent of their claims from providers in 4010 format and 17 percent in 1500 image – and that’s almost one-third of all professional claims!

HATA is working with the MGMA to address practices’ concerns, such as:

  • Practice does not want to make capital investment in new PM software
    • Practice does not understand the ROI proposition for automating the revenue cycle
    • Clinicians may be investing in diagnostic or other equipment with a more quantifiable ROI
    • Clinicians may be nearing retirement and do not want to make the investment
  • Practice does not want to invest in retraining staff or hiring new staff
  • Practice plans to upgrade both PM and EHR software together “sometime in the future”
  • Some may not literally even be aware of the various “versions” of the claims and have been using the same (probably print image) format for many years
  • Practice may be on old software that is no longer vendor-supported but has been customized by the practice

HATA plans to offer a number of free webinars at the end of August to help guide providers on how to speak with their PMS vendors regarding upgrades and other solutions. 

“HATA is committed to ensure that education is available for our practice management system members as well as the provider community at large,” Association Executive Director Tim McMullen said. “Time is running out and we want to offer sound recommendations for helping PMS vendors and their clients avoid business interruption because they are unable to submit claims with an ICD-10 code.”

About the Author

Jill Finn is the Information Technology Release Manager at ADP AdvancedMD.  She has more than 10 years of experience in the healthcare IT industry, leading teams to success across a diverse range of products, including practice management, revenue cycle management and human capital management.  She is a board member of the Healthcare Administrative Technology Association (HATA) and served on the Advisory Committee for the Practice Management System Accreditation Program (PMSAP) led by EHNAC and WEDI.

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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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