Don’t Leave Money on the Table

The Centers for Medicare & Medicaid Services (CMS) have announced the October 1, 2015 conversion date for the new ICD-10 coding system. And while there has been some grumbling about making the switch from the current ICD-9 system, we can’t help but feel that the new diagnostic and procedural codes will mark a big win for everybody in the healthcare industry—especially insurance providers.

If you are unfamiliar with the particulars of the ICD-10 codes, in a nutshell, the update allows providers to more accurately describe the amount of services and resources they need to treat their patients. By adding new levels of nuance to the coding system, doctors, specialists and hospitals will be reimbursed in a way that much more closely reflects the actual services provided.

Here’s the important part—insurers will be reimbursed more accurately, too, when they file their claims with the government. ICD-10 will open up millions and millions of dollars in revenue that was left on the table under ICD-9 and prior versions. And even better still, CMS and the government will get a better understanding of the amount of care that actually goes into treating patients, leading to improved funding in the future.

Of course, getting the most out of the new system means not only adhering to it as a health plan—but also getting your network of providers to use it, and use it accurately. This is the big trick, but it’s not impossible to pull off quickly and effectively.

At TRAFFIK, we’re invested in helping health plans develop the tools and resources to educate and empower their providers on using ICD-10 right out of the box. We’ve built apps and other organizational platforms to get physicians up to speed and help them understand the importance of being compliant with the new program.

Looking for ways to take the pain out of the ICD-10 conversion while maximizing your Medicare dollars? Call TRAFFIK today to discuss the tools and processes that are most appropriate for your health plan’s needs.