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

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

While the results showed that hospitals are focusing on employeetraining, the survey also revealed that they are leaving theirorganizations exposed to massive claims denials when the transitiontakes effect. This is because they do not understand what ICD-10codes will be accepted by the payers as it relates to reimbursementmaps and diagnosis-related group (DRG) groupings. Additionally,they are lacking denial strategies and financial models to helpthem avoid what could be a colossal claims backlogpost-transition.

"The good news is that hospitals havejumpstarted their training and documentation improvement. Thenot-so-good news is that they are not putting enough resourcesagainst understanding how their payers will operate once the ICD-10transition takes place," said Andrea Clark, chairman and chiefexecutive officer of HRAA. "This change is a massive shift in thehealthcare system and it is vital that hospitals are compliant andready on October 1, 2014."

The survey is a follow up to industry researchconducted by HRAA in April 2013 which revealed more than half ofhospitals were not complying with Centers for Medicare and MedicaidServices (CMS) suggestions and were falling behind the curve.

Hospitals Show Increase in TrainingStaff 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 formedical staff, compared to last quarter's 53 percent;
  • 76 percent plan to dual code prior to October 1, 2014, comparedto last quarter's 69 percent.

"It is clear that ICD-10 is happening, andsignificantly more hospitals have begun programs since April" saidClark. "This is vital as coder productivity is expected to decreaseby more than 70 percent with the transition. The better trained ahospital's staff is the more of a chance they can beat theseestimates."

Payer Preparations Still NeedImprovement:

While 71 percent of hospitals plan to submitICD-10 coded claims to payers prior to October 1, 2014, they arenot taking the initiative to understand how their payers aremapping their claims, which leaves them vulnerable to excessivedenials and a slowdown in reimbursements.

85 percent stated that they DONOT know if their payers are planning to map claimsutilizing CMS reimbursement maps to group the claims to DRGs.Internally, less than half (42 percent) stated that they plan touse CMS reimbursement maps to evaluate DRG groupings compared tothose based on the ICD-10 grouper.

"The survey data shows that while hospitals arefocused on testing and preparing internally, they are not focusedon mapping and the financial impact of the transition," said Ms.Clark. "We are encouraging our clients not to make assumptions butto implement technology and analytics to do the financial modelingand denial strategies now, so that they won't be playing a guessinggame with their payers once the transition takes place."

To see a summary infographic developed by HRAA, please click here.

About HRAA

HRAA (OTCQB: HRAA) interprets data to ensure that healthcare isefficient and effective for everyone by pulling medical datatogether to create a predictive window to understand cost andrevenues looking back and going forward. Founded in 2001 and basedout of Plantation, FL, HRAA combines years of industryexpertise with best-in-breed technology to create market leadingbusiness intelligence products and consulting services to ensurehospitals are reimbursed for every pill they prescribe, everyprocedure they perform and every test they administer. HRAAboth trains and supplies the high tech workforce to hospitals togenerate the predictive data used by the whole healthcare systemand offers a full suite of solutions needed to keep up with theever-changing healthcare industry including data analyticssoftware, business intelligence technology, medical coding,auditing, education, revenue cycle consulting, and ICD-10transition solutions. For more information please visit:  http://www.hraa.com

Caution Regarding Forward LookingStatements

Certain statements in this news release and such conference callare forward-looking, including (without limitation) expectations orguidance respecting customer contract expansion, growing revenuesand profits through organic growth and acquisitions, attracting newbusiness that will increase HRAA's revenues, continuing to maintaincosts and consummating any transactions. Undue reliance should notbe placed on such forward-looking statements because the mattersthey describe are subject to known and unknown risks, uncertaintiesand other unpredictable factors, many of which are beyond theCompany's control. The Company's actual results, performance andtrends could differ materially from those indicated or implied bysuch statements as a result of various factors, including (withoutlimitation) the continued strengthening of HRAA's selling andmarketing functions, continued customer satisfaction and contractrenewal, new product development, continued availability of capablededicated personnel, continued cost management, the success andavailability of acquisitions, availability of financing and otherfactors, as well as by factors applicable to most companies such asgeneral economic, competitive and other business and civilconditions. Information regarding certain of those and other riskfactors and cautionary statements that could affect future results,performance or trends are discussed in HRAA's most recent annualreport on Form 10-K, quarterly reports on Form 10-Q, and otherfilings made with the Securities and Exchange Commission from timeto time. All of the Company's forward-looking statements areexpressly qualified by all such risk factors and other cautionarystatements.
CONTACT: Media Contacts:         Danielle DeVoren / Taylor McGrann         KCSA Strategic Communications         212-896-1272 / 212-896-1253         ddevoren@kcsa.com / tmcgrann@kcsa.com

HRAA

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