Friday, March 28, 2014

12 More Months/ICD-10 Delayed?

Good News!
The news section of our website holds a very welcomed announcement.

Yesterday, the U.S. House of Representatives passed a stop-gap measure to once again extend the ambulance bonus payments for another year.

October 1, 2015 ICD-10That’s really good news!

Better News…
But even better news was another part of the same bill passage. That part sets up a delay in the implementation of the new ICD-10 coding mandate. If the Senate puts their stamp on the measure, ambulance claims will not be required to carry the new code set until October 1, 2015.

It could buy the industry a full year to prepare for the massive changes.

Out in Front
As you know from reading this blog space, Enhanced Management Services has been out in front with preparation suggestions for a few months now. The upgrade from Version 9 to Version 10 will require a big commitment from everyone.

Now, hopefully, the entire ambulance billing industry may have a full year to help the ambulance community prepare.

The provider community must begin now to take the necessary steps to ratchet up run documentation. If we have eighteen months instead of six months, you will have a full additional year to fine tune and pay attention to providing more detail when completing your Patient Care Reports.

Take advantage of education opportunities whenever possible. Enhanced will continue to include ICD-10 tie-in information in any blog we post concerning documentation.

Top EMS consultants will offer educational opportunities. If billing companies like Enhanced provide documentation instruction either live, in-person or via audio or web conferencing.

Be sure to participate. Read, listen, watch, learn.

As a patient care provider, ask questions. Be sure you fully understand the level of specific details you will need to include in your PCR documentation in order to hand your billing office the detail they will require to allow for a properly coded claim to be sent for payment.

EMS Managers, Owners, Boards of Directors, Supervisors…whatever oversight role you play, this reprieve is huge for you.

Sit down today, yes today, and map out your plan in the event that you have a full additional year to train and tweak your educational and QA/QI processes.

The industry as a whole and those organizations including state EMS associations, the American Ambulance Association and other advocacy groups can now press the Feds, CMS, State Medicaids and Commercial Insurance Payers to clearly put together an easy-to-implement mapping process that provides all of us with guidance on how to properly comply in order to insure no payment interruption.

Game Plan
Every part of the ambulance industry needs a game plan.

Draw up a budget for the worst case scenario. Even though we might have a full additional year to prepare, that doesn’t mean that the worst can’t happen.

Most likely Medicare will be ready for full implementation. Probably a fair number of State Medicaid programs will be ready come October 1, 2015.

But will the many commercial insurance companies be ready?

We believe it’s highly unlikely that they will be ready. The absence of readiness may mean cash flow interruption while they get their systems programmed to receive claims containing a potential of around 56,000 more possibilities.

So be ready for the worst and if the worst doesn’t happen at least you’ll know that you were prepared.

Remember Y2K? We all prepared. The sky didn’t fall. Nothing lost.

Once you have a reasonable game plan sit down and brainstorm all the ways that additional training, increased focus on documentation and being prepared for a reimbursement melt down can do for you positively.

Any time this industry is forced to focus on what we do there is typically a spillover into everything else we do.

Use this additional time to create better EMS in the United States.

Here to Help
Enhanced is here to help. We’ll continue to write, educate and contribute to help you prepare.

If your billing company isn’t offering to do the very same thing, then it’s time to look for a new billing company. If your billing office has no clue where to begin, you need help in finding the starting point.

Call us today. Chuck Humphrey is standing by to tell you how Enhanced can be your resource. Call him today at (800) 369-7544, Extension 108 or e-mail him at
Post a Comment