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HRAA's Industry Pulse: One Year From ICD-10 Transition, Small- And Mid-Sized Hospitals Increased Staff Training Programs But Lag In Payer Preparations, Financial Modeling And Denial Strategies

Stocks in this article: HRAA

Plantation, FL, Oct. 1, 2013 (GLOBE NEWSWIRE) -- A recent survey of 200 hospital administrators, hospital health information professionals and compliance employees conducted by Health Revenue Assurance Holdings Inc. (OTCQB: HRAA), a leading provider of technology and revenue integrity solutions for healthcare organizations, found that exactly one year out from the transition, more hospitals are taking steps to prepare for the implementation of ICD-9 to ICD-10.

While the results showed that hospitals are focusing on employee training, the survey also revealed that they are leaving their organizations exposed to massive claims denials when the transition takes effect. This is because they do not understand what ICD-10 codes will be accepted by the payers as it relates to reimbursement maps and diagnosis-related group (DRG) groupings. Additionally, they are lacking denial strategies and financial models to help them avoid what could be a colossal claims backlog post-transition.

"The good news is that hospitals have jumpstarted their training and documentation improvement. The not-so-good news is that they are not putting enough resources against understanding how their payers will operate once the ICD-10 transition takes place," said Andrea Clark, chairman and chief executive officer of HRAA. "This change is a massive shift in the healthcare system and it is vital that hospitals are compliant and ready on October 1, 2014."

The survey is a follow up to industry research conducted by HRAA in April 2013 which revealed more than half of hospitals were not complying with Centers for Medicare and Medicaid Services (CMS) suggestions and were falling behind the curve.

Hospitals Show Increase in Training Staff for ICD-10:

Of the hospitals surveyed:

  • 78 percent have begun ICD-10 CM training for coding staff, compared to last quarter's 60 percent;
  • 64 percent have begun ICD-10 PCS training for coding staff, compared to last quarter's 45 percent;
  • 68 percent have begun document improvement education for medical staff, compared to last quarter's 53 percent;
  • 76 percent plan to dual code prior to October 1, 2014, compared to last quarter's 69 percent.

"It is clear that ICD-10 is happening, and significantly more hospitals have begun programs since April" said Clark. "This is vital as coder productivity is expected to decrease by more than 70 percent with the transition. The better trained a hospital's staff is the more of a chance they can beat these estimates."

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