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October 1, 2015: It hits the fan!

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  • October 1, 2015: It hits the fan!

    Don't know if anyone is aware, but come October 1, 2015 ICD-10 (International Classification of Disease), is going to be implemented. This is a system of coding diagnoses when sending bills to insurance companies to get paid. Previously the same system has been used with codes added and deleted yearly leaving providers to keep up dated to know what codes to use to get paid. Kind of like a game. But now with this new code set, every existing code is void and new codes will replace them in a different format. A format unknown to most providers and insurance personnel alike. There has been training classes going on for about 2 to 3 years but the implementation continued to get postponed and many medical providers are not prepared.

    Iv'e attended classes, meetings, and conferences on ICD-10 and the scary thing is that insurance carriers are also confused about it, even with training, as it is not an exact science, so even if providers bill correctly, the carrier's can be making mistakes. The 10 version is a much more specific system where one code was used in the past, but now the one code has been broken down to 2,3, or more separate codes. This new coding system is used in most of the rest of the world.

    Why am I bringing this up? Well it is a complete revamp of how providers will get paid. Providers are being told they will need a 6 month reserve because payments may be scarce while working it out. Hospitals and large companies who can afford to hire attorney's and Professional coding experts will be at less of a risk, but it is not anticipated to be smooth sailing. Even coding experts have to figure out what codes different insurance entities will accept. Trial and error is what gains this information. Takes about 1 to 2 months to get payment, likewise it takes 1 to 2 months to get a denial of payment. Then research is done and a new bill is sent out with a new code. Then another 2 months, and so one. The insurance carriers will also be slowed down and transaction time may be extended to even 3 months or more.

    A friend of mine has a 2 doctor practice and has taken out a business loan to secure payment of salaries for one year. Payment will be effecting patient care. Hoping too many small doctor offices do not crash and burn.

    This on top of less reimbursement for providers, higher deductibles, more and bigger co-pays, is going to be quite a juggling act to maintain patient care.

  • #2
    Complying with Government Regulations is the biggest part of our medical costs.

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    • #3
      Oh no the US has to comply with a code that the rest of the world has already complied with for decades.

      https://en.wikipedia.org/wiki/ICD-10

      The end times are truly upon us all!!!

      ARGHHHHHHHHH!!!!!!!!!!!!!!!!!!!
      United Kingdom[edit]

      ICD-10 was first mandated for use in the UK in 1995.[13] The ICD-10 4th Edition was approved for NHS implementation on 1 April 2012 by the Information Standards Board for Health and Social Care.[14]


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      • #4
        Interesting to see this topic. I just became a CMA - not that it means much, there still are few jobs - and had to learn about ICD-9 and the coming of 10.

        It will be an interesting transition.

        Originally posted by OldmanDan View Post
        Complying with Government Regulations is the biggest part of our medical costs.
        Yes, we have to somehow pay all of the busybodies in between a Dr. and a patient. Now we have to pay an added layer of busybodies to "manage" everyone's "healthcare."

        ... and it's going to bring everyones costs down. Really it IS ! Magic

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        • #5
          Originally posted by OldmanDan View Post
          Complying with Government Regulations is the biggest part of our medical costs.
          No doubt about that OMD, but this is fuel to the fire. Of course it will settle down in time, but we will have the storm before the calm.

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          • #6
            Originally posted by PeterUK75 View Post
            Oh no the US has to comply with a code that the rest of the world has already complied with for decades.

            https://en.wikipedia.org/wiki/ICD-10

            The end times are truly upon us all!!!

            ARGHHHHHHHHH!!!!!!!!!!!!!!!!!!!
            United Kingdom[edit]

            ICD-10 was first mandated for use in the UK in 1995.[13] The ICD-10 4th Edition was approved for NHS implementation on 1 April 2012 by the Information Standards Board for Health and Social Care.[14]

            Don't get the point to your comment. Thanks for the info, but that is already know and it has nothing to do with the fact that it is going to be a costly transition for providers and problematic for patients. We should have transitioned to ICD-10 a long time ago. The transition time is the problem, on top of more and recent regulations and healthcare costs. Providers struggling to stay afloat. The delays caused problems as well. Had we switched over years ago when we should have, it would not have been the stress upon the health care providers that it may and will be today. In fact other countries are preparing for ICD-11. We are very far behind.

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            • #7
              Originally posted by Captain Trips View Post
              Interesting to see this topic. I just became a CMA - not that it means much, there still are few jobs - and had to learn about ICD-9 and the coming of 10.

              It will be an interesting transition.



              Yes, we have to somehow pay all of the busybodies in between a Dr. and a patient. Now we have to pay an added layer of busybodies to "manage" everyone's "healthcare."

              ... and it's going to bring everyones costs down. Really it IS ! Magic
              The coding system is a good thing. ICD-10 is more efficient and should speed up payment. It offers more specific details and is designed to help insurance carriers and providers to communicate better and faster. The problem is the CMS and the insurance companies don't work with the providers as they should. They negate the point of the coding system by instead trying to hold the code, they want to be used captive, having an excuse to deny and or delay payment. It's very complicated. The conversion is not exact. If the CMS participates in and allows this obstructionist practice to continue during the transition time, it will surely be very rough road ahead.



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              • #8
                Originally posted by msc View Post
                Don't get the point to your comment. Thanks for the info, but that is already know and it has nothing to do with the fact that it is going to be a costly transition for providers and problematic for patients. We should have transitioned to ICD-10 a long time ago. The transition time is the problem, on top of more and recent regulations and healthcare costs. Providers struggling to stay afloat. The delays caused problems as well. Had we switched over years ago when we should have, it would not have been the stress upon the health care providers that it may and will be today. In fact other countries are preparing for ICD-11. We are very far behind.

                It just seems that anything done by the UN is seen as an attack on the US by US conservatives and it doesn't seem to matter that the rest of the developed world signs.

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                • #9
                  Originally posted by PeterUK75 View Post


                  It just seems that anything done by the UN is seen as an attack on the US by US conservatives and it doesn't seem to matter that the rest of the developed world signs.
                  No it's not about that. Like I said, it is a system we should have adopted long ago. The switch is not bad. It's just the timing. I was ready for it years ago and annoyed when they kept putting it off.

                  Kinda like postponing a necessary surgery, then deciding to get the operation when the hospital is on fire.
                  Last edited by msc; 06-26-2015, 03:26 AM.

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                  • #10
                    Originally posted by PeterUK75 View Post


                    It just seems that anything done by the UN is seen as an attack on the US by US conservatives and it doesn't seem to matter that the rest of the developed world signs.
                    It has nothing whatever to do with what "the rest of the developed world signs." I'm sure when ICD-10 was mandated for use in the U.K., there was similar angst about adopting a new way of coding medical services (assuming you even used its predecessor, ICD-9). So get off your high horse, Peter. This is about a significant change in how we do things here and msc is absolutely right to raise the concern.

                    Medical Service Providers and Insurance Carriers ALREADY have a tumultuous relationship (not to mention now that ObamaTryToGetCare is in full swing, the various GOVERNMENTS have gotten into the "we don't pay for that" game ... if they pay at all). Changing everything around only exacerbates that relationship.

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                    • #11
                      I'm going to another conference about it in a couple of weeks. I'll share my updates of the challenges and how it may affect healthcare during this transition.

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                      • #12
                        Originally posted by Good1 View Post

                        It has nothing whatever to do with what "the rest of the developed world signs." I'm sure when ICD-10 was mandated for use in the U.K., there was similar angst about adopting a new way of coding medical services (assuming you even used its predecessor, ICD-9). So get off your high horse, Peter. This is about a significant change in how we do things here and msc is absolutely right to raise the concern.

                        Medical Service Providers and Insurance Carriers ALREADY have a tumultuous relationship (not to mention now that ObamaTryToGetCare is in full swing, the various GOVERNMENTS have gotten into the "we don't pay for that" game ... if they pay at all). Changing everything around only exacerbates that relationship.

                        The problem is you talk about all these issues that the rest of the world has obviously already solved so why is it so hard for the US health system to just take a quick look at how that was achieved and think that they may work quite well for you guys? You seem hell bent on reinventing the wheel all the time and proclaiming that the US is unique and solutions found elsewhere just won't work for you when they surely will and this could indeed be handled with little fuss.

                        I know you guys hate the the daily show but here's a clip about what I mean.
                        http://www.alternet.org/tea-party-an...-thwart-treaty

                        https://www.google.co.uk/webhp?sourc...%20un%20treaty

                        It seems pretty much anything the UN does is seen as a massive attack against US freedom.

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                        • #13
                          Originally posted by PeterUK75 View Post


                          The problem is you talk about all these issues that the rest of the world has obviously already solved so why is it so hard for the US health system to just take a quick look at how that was achieved and think that they may work quite well for you guys? You seem hell bent on reinventing the wheel all the time and proclaiming that the US is unique and solutions found elsewhere just won't work for you when they surely will and this could indeed be handled with little fuss.

                          I know you guys hate the the daily show but here's a clip about what I mean.
                          http://www.alternet.org/tea-party-an...-thwart-treaty

                          https://www.google.co.uk/webhp?sourc...%20un%20treaty

                          It seems pretty much anything the UN does is seen as a massive attack against US freedom.
                          There seems to be no benefit to the US for signing this treaty. No benefit to the disabled or families with disabled children. It encompases what is already taking place in the US and adds to more gov't control over citizens. What would be the purpose of the US signing this?

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