ICD-10 – Will Your Partners Be Ready? PART I: Project Initiation and Assessment

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Editor’s Note: The following article is the first in a three-part series on ICD-10 readiness. The series aims to help healthcare providers ensure that their vendor partners are fully prepared to comply with the implementation timeline and requirements around ICD-10 conversion.

PART I: Project Initiation and Assessment

Come Oct. 1, 2014, all healthcare providers will be required to migrate to International Classification of Diseases, Tenth Revision – better known as “ICD-10.” By now you are deep into planning your conversion. But will your vendor partners be ready?

All the planning and testing in the world will be wasted if your partners are unable to achieve ICD-10 readiness. What follows are series of suggested guidelines, based on recommendations by HIMSS and American Health Information Management Association as well as others, for managing your partner relationships related to ICD-10 conversion.

First, an overview of the ICD-10 project timeline. A typical project looks something like this:

  1. Project Initiation
  2. Assessment
  3. Design
  4. Implementation
  5. Testing
  6. Go-Live
  7. Evaluation

At every step you will need to involve your partners. Forewarned is forearmed, and if you conduct your due diligence and engage them in the process, you should not experience any hiccups at Go-Live.

Project Initiation

Any large project requires a sponsor (usually a member of the executive team), a capable project manager who will shepherd it through, and a project team consisting of a representative group of stakeholders that will either be involved in the implementation or be directly affected by the ICD-10.

Once the project team is together, one of the very first steps is to identify all the stakeholders this project will touch, and the group most frequently overlooked is vendors and other partners. Once you believe you have identified those members of the vendor community that will be affected or will affect your operation during and after the ICD-10 migration, you must reach out to those vendors to advise them that you have initiated this project and that they will be expected to participate.

At this point you must establish what the rules of engagement will be with each vendor. This will vary depending on the level of risk this vendor poses to success of the ICD-10 project. If one vendor is integrated into your billing workflow, for example, they will pose a high risk if they are not ready, and therefore must be an active participant in the project; if another vendor is peripheral, such as a collection agency, they will be less engaged.

In your initial contact with the vendor partner, you should begin to discuss the parameters of what outcomes will be expected of them. Your expectations of “vendor readiness” will also vary by vendor.

Assessment

One of the main objectives during this phase is to quantify the financial impact of the conversion to ICD-10. This includes identifying the financial risk should a vendor fail to be ready. This will provide keen insight into the amount of oversight this vendor will require through the project.

Failing to fully engage your vendors may affect your project and pose certain risks:

  • Loss of productivity, both during the project and after Go-Live;
  • The necessity to run both ICD-9 and ICD-10. You may decide to do this anyway as a precaution so that the new codes continue to reflect  the components of the service provided;
  • Accounts receivable days may increase, slowing cash flow.

Another important task is process mapping, where you will identify all business processes that in any way are affected or will affect a move to ICD-10. This is another area where many projects of this type can go astray because they fail to consider how the hand-off to vendors will change.

Up Next in PART II: Design and Implementation Phases

 

 

Chuck Seviour has over 40 years of healthcare industry experience ranging from Director of Business Office Operations for a large health system to consulting with over 150 hospitals as a healthcare consultant for a major accounting firm. Chuck has been Vice President of Revenue Cycle for Array Services Group since 2004.

 

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Posted in Billing and Coding, Medical Receivables, Patient Experience, Patient Financial Services, Revenue Integrity .

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