RCM: Survive the Cash Crunch

No matter what you do to prepare your ophthalmology practice for ICD-10 implementation on October 1, 2015, there will almost certainly be glitches you can’t control.

That’s why your fourth quarter budget should allow for a dip in productivity as your billers and coders adjust, as well as the almost inevitable delays you’ll see among payers processing your claims.

A small practice will see a cash flow disruption of almost $20,000; medium practices will face a $65,000 shortfall, and large practices will come up $650,000 short, predicts one practice management consultant. Want to make sure you can make payroll even if ICD-10 snafus temporarily halt your cash flow?

Some experts recommend you secure a line of credit for about five percent of the total reimbursement your ophthalmology practice expects to earn this year. To prevent cash flow disruptions, allocate more staff time to claims monitoring during Q4. More than ever, you will want to know if payers aren’t reimbursing you correctly so that you can get appeals moving quickly.

Prepare for Q4 Claims Monitoring Now: Identify the top 25-50 ICD-9 codes your practice is using now and ask your payers for the crosswalk mapping tool they are using. See for yourself how your most common ICD-9 codes will likely translate to ICD-10 using online mapping tools such as this one.

Once your crosswalk reveals the ICD-10 codes you’ll likely be using, review the essential elements your clinical staff will need to include in your documentation, such as laterality, acuity, location.

Sources: Supercoder, Angie Comfort, RHIA, CDIP, CCS, senior director of HIM Practice Excellence, Coding Services, for AHIMA, Michelle Cavanaugh, RN, CPC, CANPC, CGIC, CPB, CMRS, an AHIMA-approved ICD-10 trainer and RCM manager at Kareo.

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