Hospitals: Get ICD-10 Prepared

The transition to ICD-10 will affect the staff, revenue cycle processes, and technology infrastructure of a hospital. To receive accurate and timely reimbursement, hospitals need to use software that can handle the complexity of ICD-10—which includes almost eight times as many diagnostic and procedural codes than ICD-9.

Business Issues

Hospitals are likely to experience trials during and after the implementation of ICD-10 including:

Increased reporting requirements for inpatient services
Older technology systems that cannot support increased diagnosis and procedure codes required with ICD-10
New value-based purchasing initiatives for hospital physicians may be introduced
Increased demand and investment in electronic health record (EHR) applications
Increased coder shortage and attrition as coders leave rather than learn a new coding system
Increased need for computer-assisted coding (CAC) solution to improve documentation and coding processes
Improved clinical documentation required to support higher level of specificity within ICD-10
Decreased productivity and accuracy due to coding backlogs and a steep learning curve
Increased time and expense to train clinical and non-clinical staff on ICD-10 code sets
Increased claim denials and reduced cash flow from Provider and payer processing errors

Partner with Ingenix

Questions to ask

Why should you consider OptumInsight as an ICD-10 partner?

In order to make a seamless and efficient transition to ICD-10, organizations need to start preparing now.

OptumInsight can help you use the transition to ICD-10 to your greatest advantage. With OptumInsight consulting services, technology, and data, you can begin identifying impacts and developing plans for an efficient, effective, and compliant conversion.

OptumInsight understands every facet of the health care system. Because we provide services to payers, hospitals, physicians, government agencies, and other health care stakeholders, we bring a strategic perspective unmatched by other information technology providers. Our solutions are informed by 25 years of experience in coding, payment, and reimbursement methodologies.

OptumInsight provides the following ICD-10 solutions:

Computer-assisted coding technology that integrates with Web.Strat, an ICD-10 facility encoder with an optional integrated compliance module, to ease the transition
ICD-10 consulting services which include executive education, gap analysis, project management, and implementation planning
Coding resources, including code description tables, OptumInsight Global Code Management Toolkit’s sophisticated mapping software, and reference manuals to help hospitals gain a better understanding of the new coding system
OptumInsight technology solutions will be ICD-10 and 5010 compatible in advance of deadlines to enable clients to implement, test, and optimize needed upgrades.

Critical questions every executive should be asking:

Do I trust that vendors of my critical IT systems will be ready by the ICD-10 deadline?
How much time do I need to upgrade my older systems?
Which aspects of the ICD-10 transition should I outsource?
How do I implement a training program that is appropriate for different roles within my organization?
What is my information systems implementation strategy?
How do I use general equivalency mappers (GEMs) to analyze the difference between ICD-9 and ICD-10?
Is there a program that helps coders learn more about anatomy, physiology, and interventions to aid in coding accuracy and efficiency?
Will I be able to translate historical data and will I still be able to use that data with ICD-10?
Will this affect state and federal reporting requirements?
How will this affect my clinical documentation program?
Will this change my payments from Medicare for never-events or present-on-admission (POA)?