Cash Reserves
Some hospitals and physician groups are putting aside reserves in case of interruptions in reimbursement, said Lana Cabral, senior director of case management services for Conifer Health Solutions, a unit of the hospital company Tenet Healthcare Corp. Conifer, which processes bills for doctors and hospitals, has set up a “command center” to manage the transition, she said.
Conifer has helped doctors and their staffs train for the change by teaching them to be as specific as possible in using the new codes, she said.
“If we’re using codes that are less specific, it results in lower acuity,” she said. “That doesn’t mean you don’t get paid or don’t get paid on time, but you may get less money.”
Athenahealth Inc., which sells and maintains billing software for Masucci and other health-care providers, has been working for years to prepare for the new codes, said Todd Rothenhaus, chief medical officer for the Watertown, Massachusetts-based company. Despite efforts by insurers and billing services companies, there are bound to be glitches, he said.
“I guarantee you that some practices will not have a single claim dropped, and there will be others that will have no claims paid,” he said.
Rothenhaus said that the biggest concern for his clients is local insurers, such as state Blue Cross/Blue Shield plans that make up a large proportion of some providers’ bills. If these plans fail to implement the new codes properly, it could hurt individual doctors, he said. The company will be issuing reports on the performance of the new system and looking for trouble spots, he said.
And if, even after all the efforts to get the transition right, doctors and hospitals are still dealing with problems, there’s an ICD-10 code for that -- F43.22: “Adjustment disorder with anxiety.”