ICD-10 Implementation: Have You Begun to Reach Out to Your Clearinghouse and Payers?
In preparing for ICD-10 implementation, it is imperative that you start to form relationships with your clearinghouse and payers.
Some of the key areas of discussion should be:
Payers and Clearinghouse
- Establish a key contact for the ICD-10 implementation process and set up monthly meetings and/or conference calls to discuss their current status and any questions or issues you may have.
- Determine where they currently are in ICD-10 transition and what their testing timelines and testing requirements are.
- For hospitals specifically – review current contracts that have carve outs for enhanced reimbursement and determine if the contracts need to be updated.
- Determine if there will there be any new policies/procedures (i.e., prior authorizations/referrals based on ICD-9 diagnosis and procedure codes) that you need to be made aware of.
- Determine what their process for delays in payments or incorrect denials be handled and if there will be a dedicated contact or department to resolve those issues.