The Coalition for ICD-10 presents the second installment of its Member Spotlight series with the focus on The Professional Association of Healthcare Office Management (PAHCOM).
The Professional Association of Healthcare Office Management (PAHCOM) continues to advocate for smaller physician practices. We are the voice for practices of all sizes and models that often do not have the resources available that many large corporate entities or hospital based physician group practices have in place. The initial roll-out of ICD-10 CM preparedness guidance appeared such a daunting task that many small physician practices chose to stay in denial regarding the importance of implementation.
The Office Manager in this setting is usually an army of one to include the HIM manager, Coding Manager, IT Manager, HR Manager not to mention credentialing, contracting and vendor relations manager. The changes in technology alone required by HIPAA security, privacy, EHR implementation, meaningful use etc. have stretched budgets and available staffing to the breaking point.
PAHCOM continues to engage its membership in skill development programs led by industry experts in the implementation of ICD-10 CM and to re-enforce the long term benefits and increased profitability afforded by preparedness. Tools have now been developed by CMS, Specialty Societies and State Medical Associations that breakdown this overwhelming task into obtainable steps that every practice should now be able to adopt with less trepidation. The Manager can now feel comfortable in recruiting staff members who they deem capable to lead specific steps of the transition, armed with these newly available tools, checklists and resources. This information provides the manager an opportunity to break the process down into phases, clearly representing the role each member of the team will play in the overall success of the practice. These tools give managers the necessary information to design a visual project work plan that works within the operational confines of their practice. A focused plan, tailored to work within the existing practice structure is paramount to a successful implementation. There is no need for proficiency in the entire code set, only within the individual practice’s area of specialty.
Transition to ICD-10 is not an option. Managers are encouraged to promote the positive benefits to staff and physician leadership to get them engaged. A solid work plan that includes everyone in the practice can reinforce the importance of the transition and foster a sense of shared responsibility for a successful outcome. With the various physician practice models emerging in healthcare today there is no one size fits all implementation plan. Completing an ICD-10 assessment of the practice is the best place to start. Once that is completed the task is not as daunting as it first appeared.
The recent delay coupled with the newly available implementation tools will provide many small to medium sized practices with the opportunity to design a plan unique to their needs, while still leaving time to focus on: documentation improvement, biller and coder education, mock implementation workgroups to get more comfortable with the new codes, engaging staff in building tools and tip sheets for their department, and query forms for helping physicians reach a proficiency level. Additional time also affords opportunities for increased end to end testing.
Physician engagement tips:
Revenue cycle management will be the guiding factor in presenting a strong business plan to physician leaders. We all know the industry recommendations regarding cash reserves necessary for the ICD-10 roll-out have created a negativity barrier that will be difficult to break down. To combat this, a positive revenue impact philosophy needs to be introduced emphasizing the long term benefits. These include decreased denials, timely authorizations and clarity reflecting the risk and severity of the services afforded by the ICD-10 code set. The result will be timely reimbursement, increased staff productivity for coders and billers with fewer appeals and improved data related to non-compliant patients that can currently impact physician quality data negatively.
PAHCOM continues to advocate for small practice considerations in their plans for ICD-10 implementation programs. We are committed to sharing knowledge and providing platforms for networking, discussion and problem solving. We provide ease of access to training resources, testing schedules, programs with payers and education sources for managers, staff and physicians. This is a daunting task for so many small practices. We are proud to support them and provide them with a voice on a national level.