by Holly Holt May 13, 2013
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AdvancedMD, Claims, Coding, Regulatory, Training

ICD-10 Vendor Readiness

All of the leading experts in the health-care industry are stressing the importance of contacting your vendors to assess their readiness for ICD-10. It is vital that they can accommodate your needs for ICD-10, right? Of course!

Have you contacted your vendors yet? Let’s get started on your homework right now!

Below are the questions we recommend asking all of your vendors. For your convenience, I have also saved you a call by also providing the responses from your “favorite” vendor – ADP AdvancedMD.

ICD-10 Transition Q&A

When will your system be updated?

ADP AdvancedMD: Currently we have already made some ICD-10 related changes to our products, such as giving you the ability to import ICD-10 codes in the PM. Other configuration-related changes have been made behind the scenes. You can count on us to fully update the system well before the Oct 2014 compliance date, to give your office time for testing.

Are there any costs involved in system upgrades or other ICD-10 modifications?

ADP AdvancedMD: There is no additional charge to get your office key upgraded and fully functional for ICD-10 as it is included within your monthly subscription fee. We will also be offering free webinars and ICD-10 product trainings. Subscribing to our ICD-10 website is also free.

Are there hardware requirements associated with ICD-10 related software changes?

ADP AdvancedMD: There are not any new hardware requirements specifically for ICD-10. Please view our System Requirements page as requirements will change as technology advances.

Product-Specific ICD-10 Features Q&A

What screen modifications are expected in the system?

ADP AdvancedMD: In additional to adding ICD-10 fields throughout the system, charge entry screens will be equipped with a mapping tool to help coders select the appropriate ICD-10 code.

ICD-10 Testing Q&A

What is your testing strategy?

ADP AdvancedMD: All ICD-10 system modifications will be tested extensively prior to being released. We will start internal ICD-10 testing with our clearinghouse RelayHealth in 2013. Clients will be able to test live ICD-10 claims 6 months prior to the Oct 2014 compliance deadline.

ICD-10 Training/Resources Q&A

What ICD-10 training(s) will you be offering?

ADP AdvancedMD: Our ICD-10 Posse is working hard to help ensure your practice a smooth ICD-10 transition. Be sure to visit and subscribe to our free ICD-10 website where you can view all of our upcoming webinars on topics such as:

  • ICD-10 Implementation Planning
  • ICD-10 Impact Assessment
  • Physiology & Anatomy Training
  • Clinical Documentation – Chart Audits
  • ICD-10 Code Set Training

What other training and ICD-10 resources do you recommend?

ADP AdvancedMD: There are some excellent ICD-10 resources out there to help you stay informed on ICD-10 news, training resources, and other helpful tips. Our posse has collected the best of the best for you on the ICD-10 website.

My ICD-10 Timeline Website

ADP AdvancedMD is your partner in transitioning to ICD-10. Our comprehensive ICD-10 implementation strategy was created with your needs in mind. With ADP AdvancedMD, you can feel confident that your Practice Management and Electronic Health Records systems will be compliant and fully functional prior to the October 1, 2014 deadline.

Our newly launched ICD-10 website contains the ICD-10 Implementation Planning Guide (Trail Map) and an Assessment Tool to walk you through the transition process, including links to upcoming webinars and valuable ICD-10 resources.

You can also follow the ICD-10 posse on Twitter.

 

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by David Maxwell April 22, 2013
1 Comment
AdvancedMD

ICD-10 and the Boy Who Cried Wolf

We all know the story from Aesop’s Fables of the boy who falsely cried “Wolf!”, only to have a real wolf appear and no one believe him. After last year’s change to the October 2013 ICD-10 implementation date, many doctors are left wondering if CMS will once again cry “Wolf!” on the planned October 2014 implementation date. Is ICD-10 in October 2014 a “Wolf!” or a real wolf?

It’s looking more and more like a real wolf.Wolf_2

In a February 2013 letter to the American Health Information Management Association (AHIMA), Robert Tagalicod, acting on behalf of HHS Secretary Kathleen Sebelius, reaffirmed CMS’s commitment to maintain the Oct. 1, 2014 ICD-10 transition date. The letter states that “CMS believes that the one-year extension [to Oct. 2014] offers physicians adequate time to train their coders, complete system changeovers, and conduct testing.”

In an address given March 6, 2013 at the 2013 annual HIMSS conference, Marilyn Tavenner, Acting CMS Administrator, reaffirmed the Oct. 1, 2014 date and CMS’s intention to hold to that date. It was Ms. Tavenner who first cried “Wolf!” in February 2012 by announcing that CMS would reconsider the planned October 2013 ICD-10 transition date. Her announcement last year of a delay in implementation came 19 months prior to the planned transition date. Now, at about the same time away from the new transition date, she is reiterating commitment to the date rather than backing away from it.

In its Aug. 24, 2012 final rule (that established the one year delay), CMS already considered a two year delay as one of the possible options. The final rule stated that a delay in ICD-10 implementation for an additional year (to 2015) would also necessitate unfreezing the currently frozen ICD-9 and ICD-10 code sets. The analysis of the impact just to unfreeze the code sets estimated an additional $2 billion in industry costs.

Currently the ICD-9 and ICD-10 code sets are in a “partial freeze” status, meaning that only limited code updates will be made this year. Next year, only limited code updates will be made to the ICD-10 code set and no updates will be made to the ICD-9 code set. In 2015 regular updates to the ICD-10 code set will begin. The fact that the partial freeze status has not been lifted lends additional credence to holding firm on the October 2014 date.

CMS cried “Wolf!” once on the ICD-10 transition date, but ICD-10 for next year looks more and more like the real thing.

Now’s the time to prepare for the wolf. Register on our ICD-10 site to access all the resources you need to get ready. Let’s make sure that the story for your practice ends more happily than the fable.

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by BJ Vander Linden March 27, 2013
Training

7 Tips to Help EHR Implementation go from Mountain to Molehill

Mountain to molehill.

For many, implementing an EHR solution can feel a bit like climbing Mount Everest. If you don’t have the right gear, leadership, and guidance, it could be a rough climb.

To help private practice physicians navigate this terrain, I have put together some advice and suggestions on how to create an implementation plan to achieve successful outcomes across all areas of your practice.

In a recent Medical Economics article, I proposed “Seven Best Practices for Implementing EHRs.” Some of my tips include: identifying an EHR champion, testing new workflows, and aligning with your practice’s “big picture” goals.

Although these tips are intended for new implementations,  we also have resources for practices in all stages of the implementation process, including:

Still have questions? ADP AdvancedMD is here to help: send us an email, tweet, or post on our Facebook page.

by Mike Bearnson November 26, 2012
AdvancedMD, Claims, Coding, Regulatory, Training

Solving the ICD-10 Equation

ICD-10 ready software + Prepared Health Care Offices =

Successful ICD-10 Implementation

We now have less than two short years in order to prepare for the October 1, 2014 ICD-10 deadline. Successful implementation will take effort by physician’s offices and their vendors.   With this in mind, you might have some questions when it comes to the ADP AdvancedMD side of the equation.

In November of 2010 Physician’s Practice Magazine published 5010 & ICD-10 transition checklists to ask your practice management system vendor.  The questions for the 5010 transition were answered in a separate blog post.  Below are the questions and ADP AdvancedMD answers for the ICD-10 transition.  (Click here for the Physicians Practice Article)

• When will your product be upgraded to support ICD-10?  By leveraging our cloud based system our clients have already seen upgraded functionality and will continue to see these enhancements throughout the next two years.  We are on track to a fully functional and tested ICD-10 product by the October 2014 deadline.

• When will we be able to run test claims using ICD-10? We are currently working with our integrated partners building the foundation and testing integration connections.  Once complete,clients will be able to beta test with live claims by the first quarter of 2014.

• Is the upgrade to ICD-10 included in my ongoing maintenance expense?  Absolutely!  As with most enhancements, ICD-10 functionality is included in with your monthly subscription fee. Changes to functionality will be included in our general releases and all of our clients will be able to process their claims using the ICD-10 codes. 

• Will ADP AdvancedMD’s practice management (and/or electronic health record) software include a searchable ICD-10 database?  Yes!  ADP AdvancedMD already provides a searchable ICD-10 database with our current product.  Although you are not currently able to process a claim you can start familiarizing yourself with the new ICD-10 codes.

• Will your product support both ICD-9 and ICD-10 during a transition phase? Do you have projected dates for the transition phase?  Yes!  We will be supporting our client’s ability to process claims using either ICD-9 or ICD-10 for the foreseeable future.  The transition dates will depend largely on our client’s payers and their ability to accept ICD-10 codes.

• Will we be permitted to migrate to ICD-10 prior to October 1, 2014?  Yes, although many payers will not be processing live claims based on ICD-10 codes until after the October 1, 2014 deadline.  If payers are ready to accept live claims prior to the deadline, ADP AdvancedMD will be able to accommodate clients in our beta program in 2014.

This should answer some of the basic questions you have, however as I stated at the beginning of this blog, while ADP AdvancedMD plans to provide you a fully functional ICD-10 product; this will not be enough to ensure your success through this important implementation.  You will need to work through your side of the equation and we are here to help.  ADP AdvancedMD has gathered an ICD-10 ‘posse’ of associates that represent every department of our company and in the coming months the posse will be working to provide you information, resources, training and the help you will need in order to prepare your office for the new ICD-10 code set.

If you want a head start before the New Year, click here for a great article from CMS (You will need to adjust the dates back 1 year, due to the extended deadline.  So where it says “2013”, replace with “2014”).

Hot on the ICD-10 trail…

by David Maxwell September 13, 2012
AdvancedMD

It’s not quite Angry Birds, but this new game helps medical practices improve security

A patient wants a copy of his personal health record and offers to bring in a USB drive for you to copy the record onto. How do you respond?

This is just one of 16 different common security scenarios encountered by the typical medical practice found in a new game released by the Office of the National Coordinator for Health Information Technology (ONC). The game is a fun way to teach practice staff the importance of security and to remind them how to act when faced with potential security violations.

In the game, the user encounters potential security issues in different areas of the medical practice and must choose how to respond to each scenario. As the user chooses correctly, points accumulate and the medical practice flourishes:  new equipment and rooms are added and patients flock to the practice. If the user chooses incorrectly, points are lost and equipment and space are removed from the practice.

The game teaches as well as entertains and does so in a fun, real-world simulation. You’ve probably already faced some of these same situations (or similar) in your practice.

So if you’re looking for a new way to reinforce important security principles in your practice, try playing the ONC game. You can even run a competition and have the entire staff post their scores for bragging rights! Good luck!

The ONC game can be found here: http://www.healthit.gov/providers-professionals/privacy-security-training-games

by Steven ZoBell August 1, 2012
AdvancedMD, Coding, Regulatory

Introducing the ADP AdvancedMD 2012 Summer Release and iPad® App for EHR

The ADP AdvancedMD 2012 Summer release aims to make life easier and more more profitable for physicians, while untethering them from their desk!

Howdy!  I am excited to share some details on an important milestone we have reached with the ADP AdvancedMD 2012 Summer release http://www.advancedmd.com/company/news-events/press-releases/adp-advancedmd-unveils-ipad-app-for-medical-practices/, which introduces important improvements to the AdvancedMD cloud as well as our exciting new Apple iPad® app designed with the physician in mind.

In considering product improvements, we look to our physician product advisory group as well as our internal experts, who continually advocate for simplicity, stability and portability in their workflow.   We’ve made these our goals in our long-term product roadmap as well as with incremental changes in every release.

Simplicity – AdvancedMD on the iPad helps you easily perform clinical duties –like completing a simple patient note, viewing a lab result, or accessing patient history with amazing speed and flexibility.

Stability – You won’t have to adjust your workflow or lifestyle because of this release.  You already have enough moving parts without your software getting upended. We have harnessed the industry leading power and flexibility from the scheduler of our AdvancedMD cloud with a design on the iPad app to match your scheduling process that is simple, easy and intuitive.

Portability – Our goal of untethering the physician from their desk and office has been accomplished by allowing access to patient history, notes and problem-lists quickly and seamlessly in our iPad app.  In addition, the app’s messaging allows physicians to securely communicate others in the practice, quickly and easily.

However, we didn’t just work on the iPad app, there are many great additional updates to the AdvancedMD cloud in the 2012 Summer release as well -

  • User Experience –A simple, retooled new look to the desktop environment makes it easier to work across all aspects of the solution for greater clarity and ease of use.
  • Enhanced Credit Card Management – As a continuation of the robust and integrated credit card solutions introduced in 2011, practices can simplify their process of collecting the patient portion of their services. You can add patient credit cards, manage payments, automatically process and collect balances prior to generating statements, all within the AdvancedMD cloud.
  • Credit Balance Transfer – A practice now can apply credit patient balances within a family from one patient to another, improving speed of payment as well as patient satisfaction.
  • Patient Photos – Adding a photo through an easy one-step process keeps a visual reminder with the patient record so everyone in the practice can provide quicker, more personal service to patients and help avoid “wrong chart” mistakes.
  • Pediatric Workflow – Improvements to pediatric EHR workflow enables faster data entry during charting and simplified steps to accomplish commonly used functions such as vaccine entry and creating and printing growth charts.
  • ICD-10 codes – While the regulations have not been finalized, a change from   ICD-9 is inevitable. The ADP AdvancedMD 2012 Summer release allows practices to begin familiarizing themselves with the migration to the next generation of clinical coding.

The AdvancedMD iPad app is available now for customers to download on their iPad at no additional charge through the Apple App Store.  You can tour the new iPad app and new release features, in these online demos and resources:

ADP AdvancedMD Resources­­­­­

 

by Colette Weston May 10, 2012
AdvancedMD, Claims, Regulatory

5010 in the Rearview Mirror

I have spent the past couple months reflecting, watching claim statistics across our client base and reading the latest of industry news.  It never surprises me that planning and statistics can only take the pursuit of knowledge so far.  There is no replacement for hands on, in the trenches, experience.

A discovery over the last month or so was that the claim statistics for exclusions (clearinghouse), rejections (carriers) and denials (carriers) across our client base were holding within pre-5010 ranges.  While encouraging news, I couldn’t quite get thoughts on paper to post to this blog.

As it happened a quarterly meeting with our Product Advisory Group was scheduled in April, so we put the topic on the agenda to show the advisors the statistics and get their thoughts.  It was apparent early on in the conversation that while the day to day claim submissions are statistically back to normal, in the trenches of the day to day, there is still ongoing cleanup.  The providers submitting the claims for their services are left with above average clean-up and claim chasing as a result of all healthcare parties adjusting their systems/edits during the transition to 5010.   I estimate that those in the trenches won’t feel relief/settling for another month.   If you are still in the middle of the claim chase, stay with it, there is an end in sight.  Just in time for summer vacations!

by Colette Weston March 20, 2012
AdvancedMD, Claims, Regulatory

5010 Compliance Deadline DID NOT CHANGE

Since the first of the year, I have been out visiting clients and am not surprised to find confusion around CMS and the 5010 Discretionary Period, which, as of late last week, was pushed to 6/30/2012.  I find confusion not only in our busy client offices, but across the industry as well.  It is important to know that Discretionary Period does NOT equal Deadline.  The deadline for 5010 compliance has come and gone.  The 5010 Compliance Deadline is/was 1/1/2012.

Online dictionaries define Discretion as “the power or right to decide or act according to one’s own judgment”.  In other words, CMS’ announcement is that they will not penalize all who are not in compliance with the 5010 Deadline of 1/1/2012.  They will decide on a case by case basis.

So what exactly should be happening in the discretionary period?

  • Everyone should be transmitting in 5010, as the compliance deadline of 1/1/2012 has come and gone.
  • If you are not able to transmit in 5010, you have 30 days to submit a transition plan to your Medicare Administrative Contractor (MAC).
  • What happens if you don’t submit a transition plan?  You run the risk of the MAC rejecting your claims for non-compliance.  As of the date of this blog post, CMS Fee-For-Service has not instructed the MACs to reject claims.  There is not a guarantee or set date on when that instruction will take place.  I assume CMS is still assessing the readiness and compliance of the industry as a whole before they will make that decision.
  • Many are confused and have asked, what are the penalties for violations of the HIPAA regulations for transactions & code sets (of which 5010 is a part)?  The answer on CMS.gov is not more than $1.5 million per calendar year in civil monetary penalties.  I don’t know of any entity in this business that can afford to part with hard earned money.

I am pleased to report that the four OB/GYN offices I visited in Michigan last week were in good shape and have felt minimal impact of the 5010 transition.  I also realize that is not the case for every office out there.  In the busy day to day business of our client base and the tens of thousands of other providers in the healthcare industry, this HIPAA requirement of transitioning to the 5010 format for some has been much more than disruptive.  I encourage all to keep plugging away at the clearinghouse exclusions, rejections and denials.  I know at times it seems reverting back to 4010 is a better option and some are using the discretionary period as the justification, but it is not a viable option.  Many carriers, aside from Medicare have transitioned fully to 5010.  While your clearinghouse and/or vendor may take your 4010 file and convert to 5010, it is likely that some key 5010 information will be missing, as that information wasn’t part of the 4010 file, thus bringing us full circle to why we are transitioning to 5010.   Attack the issues your practice encounters with 5010 head on and secure the financial cash flow of your business.  I know there will be light at the end of this tunnel, and it won’t be a train!

Share your experience with me:  cweston@advancedmd.com

Reference:  https://questions.cms.hhs.gov/app/answers/list/kw/enforcement/search/1

by Colette Weston February 2, 2012
AdvancedMD, Claims, Coding, Regulatory

Thirty days into 5010… is there an ICD-10 code for this?

A month into 5010 and the fall out for all involved is frustrating, disruptive and at times financially devastating.   I knew that a single deadline for all parties involved would cause additional challenges, but the constant adjusting of the radio dial (mentioned in my previous blog post)  is not only disruptive, it is becoming almost impossible to track/follow.

Yesterday, the Medical Group Management Association (MGMA) sent a letter to The Department of Health and Human Services (HHS) outlining the 5010 challenges their 22,500 members have reported.   Mentioned in this letter is a CMS Open Door Forum Call that took place last week (1/25/12).  I and a team of our developers responding to 5010 were on the call.  The MGMA letter mentions what our team here at ADP AdvancedMD felt was the most significant issue that came to light on the call.  That issue being the electronic packaging of claims (files) and the number of claims included in each electronic file.  CMS communicated that the MACs are seeing a significant backlog of electronic claim files.  The problem appears to be with any electronic file including over 5000 claims, or files with just one claim.  As a result of this backlog of claims to process, practices are resubmitting claims as the MACs do not show the claims as received.  Others practices are dropping claims to paper and submitting.  Both of these actions (electronic resubmission and paper) are further exacerbating the backlog.  It is a cycle that very quickly is spinning our industry out of control.

Of the action steps recommended to HHS in the MGMA letter, I believe the lifting of the 5010 edit requirements is most significant.  The discovery under volume that our industry is not ready to handle the claims load in this new format, I believe needs to be addressed first.  (Claim file load just wasn’t something that was tested.  The industry was focused in testing their code to ensure it met the 5010 format requirements.)   The data element edits can be added back in at a later date.   MGMA is proposing a push back of the 5010 format requirements to 6/30/2012.  I am in complete support of that proposal.  The volume issue and claims backup MUST be addressed quickly.   Not only are the electronic communications backing up, but customer services lines across the industry are seeing the same strain.  Call hold and response times are increasing not only with new issues that come to light, but as practices call to recheck status of a claim (carrier) or programming issue  (clearinghouse / vendor).   Billing professionals are forced to reassess claim files daily in an attempt to figure out where the file is now (a daily Where’s Waldo of claims status), requiring them to spend hours on the phone to track claims.      Customer Service professionals at carriers, clearinghouses and vendors are overloaded and having the same difficulty in keeping up with the flow (or lack thereof) claims.

With the backing up of claims, even those claims that meet the 5010 edit requirements are waiting in line.  Some of our client base is now reporting up to a 2 week delay at this point before the carrier is recognizing receipt of the claim.   It doesn’t take a healthcare economist to see that the effect of the past 30 days is going to have far reaching negative financial impacts.

Pain little closer to home for me is the longer hold times of our clients with our customer support team.  We are experiencing hold times 4x greater than times prior to 1/1/2012.  Our focus is clearly on 5010, with a team that is dedicated solely to reacting to 5010 needs by daily reviewing the top exclusions and edits across our client base.  With this dedicated focus, they are determining if the exclusion or edit can be resolved within the data that our client has the capability to change, or if a change is needed by AdvancedMD or our clearinghouse partner.  To our clients, I want you to know that we are concerned with the state of our industry and are diligently working behind the scenes on your behalf and will continue, to ensure we can help in any way we can to alleviate the potential chaos you are experiencing.

I wonder, is there an ICD-10 code for stroke caused by stress related to healthcare claim payment delays?

 

References:  http://www.mgma.com/WorkArea/DownloadAsset.aspx?id=1369699

by Colette Weston January 19, 2012
AdvancedMD, Claims, Regulatory

The status of 5010 … an analog radio dial

For the past couple weeks I have been watching industry news, alerts from our clearinghouse and exclusions, rejections and denials from our client base.  To say the least the picture is still in a constant flux of adjust and react.  The sheer volume of data that is being transmitted in the new format has brought to light issues that just weren’t detected in the smaller test batches.

Here’s what I’ve seen:

  • Many of our clients were busy running their practices and the 5010 deadline snuck up on them.  These clients generally received clearinghouse exclusions for using a PO Box and not transmitting a 9 digit zip code.  These edits got their attention and reminded them of the deadline.  More importantly they were easy to resolve.
  • The success or lack of success on claims getting through to the carriers payment floor is largely dependent on the provider’s specific data, specialty and the payer.  We have some clients with their top payers sailing through to the payment floor, while others hit a solid wall of edits.
  • Many payers have pulled back from 5010 for a short period of time (days) as they adjust their systems, before instructing the clearinghouse to once again transmit in the 5010 format.
  • Our clearinghouse has been able to identify a couple tweaks needed within their programming for 5010 through payer adjustments and a larger volume of data.
  • We have had a couple unforeseen edits come to light and have adjusted our programming to accommodate.
  • Some payers are requiring new electronic data interchange enrollment of the providers and/or verification of the provider’s ability/desire to transmit in the 5010 format.
  • Support assistance needs are significantly higher than expected across the board.  (At vendors like ADP AdvancedMD, clearinghouses and payers.)  Hold times for all of these service centers are higher than I have seen in years.
  • Other practice management software vendors that are not natively built in the cloud are seeing a similar picture, but requiring significantly more resources to disseminate updated versions of their software to their end user.
  • The status of the industry picture is fuzzy and in a constant state of change as one player adjusts, everyone communicating with that player needs to react.  At times, I have seen claims that were going through in the 5010 format now hitting an edit.

Unfortunately, I believe this fuzzy picture of the 5010 landscape is going to be in place for at least the next 3 months as each player in this electronic data interchange world dial in their systems and react to the adjustments of others.  It’s an interesting healthcare billing world, ADP AdvancedMD is here to help in the fine tuning of that electronic data radio dial.