A Race to the ICD-10 Finish Line

With less than 8 months until the mandated October 1, 2015, ICD-10 implementation deadline, it is now a race to the finish line for many small to mid-sized health plans and providers. While there is a very small minority that think there will be another delay, CMS and Congress have constantly reiterated that the ICD-10 deadline will not be delayed any longer because of the high cost of the last extension and the overall readiness of the industry.

ICD-10 testing results to date have been very positive. During the November 2014 testing period, CMS processed 13,700 claims from more than 500 providers, suppliers, billing companies, and clearinghouses and ultimately reported that “testing did not identify any issues with the Medicare FFS claims systems.” Overall, CMS accepted 76% of test claims and acceptance rates improved throughout the testing period with a final acceptance rate of 87%.

In a recent AAPC ICD-10 Testing Survey of over 2,000 respondents, it was reported that:

  • 84% of those who had taken part in ICD-10 testing considered it to be a success
  • 72% of respondents saw no claims denied during testing
  • An additional 16% experienced a rejection rate of less than 10%
  • More than 90% of respondents noticed no payment shift on test claims

This is just a sample of the recent successful ICD-10 testing results being reported. Many of the large health plans, hospitals, and multispecialty physician groups have been ready for some time and are now actively continuing their end-to-end testing efforts. While it will be easy for these payers to finish the last couple of laps in the race to the ICD-10 finish line, many others haven’t even left the starting blocks! Unfortunately for these payers, it will be an all-out sprint to the finish line for their ICD-10 implementations. Will they have the resources and stamina to catch up and ultimately cross the finish line in time?

The small to mid-sized health plans and managed care payers that are not on track to finish the race can learn from others who are already nearing the finish line in order to expedite their testing efforts and achieve readiness. HCIM and AXIOM Systems have the industry knowledge and best practices experience to coach you through a successful implementation. For more information, call 888-454-0202, option 5 or email sales@hcim.com.

Update: Feb. 11, 2015 Capitol Hill Hearing Examining ICD-10 >>
ICD-10 passes end-to-end testing according to CMS chief Marilyn Tavenner >>

Michael Wilson, President and CEO of HCIM

Michael Wilson

President & CEO
HCIM Co-Founder

About HCIM

Since 2000, HealthCare Information Management, Inc. (HCIM) has delivered expert consulting services and robotic automation tools for small to mid-sized healthcare payer and managed care organizations. Our concierge consulting services include everything from core claims system procurement to go live, including configuration, migration, upgrades, reporting, benefits and fee schedules, user training, and project resourcing. We also offer strategic consulting in the areas of value based payments, population health, medical management, medical loss analysis and recovery, care management, provider contract modeling, data analytics, and business process reengineering/analysis.