The following information (Part 2 of 4) was from a tweet stream emanating from the Edifecs ICD-10 Summit held on February 15 & 16th. Find more information about that event here => click here
Survey About “Neutrality”
- If you don't define neutrality, you run the risk of miscommunication.
- Defined #1- Maintain the current claims acceptance rate.
- Defined #2 - Maintain the number/rate of inquiries.
- Defined #3 - Maintain the rate of electronic claims.
- Defined #4 - Maintain the claims reimbursement amounts.
- 6 Dimensions of Neutrality: Payment, Benefit, Revenue, Clinical, Operational and Financial.
- Payment: ID where DRG shift can occur, likely impact and ways to get back to neutral.
- Benefit: No expansion or reduction in benefits or out-of-pocket costs.
- Revenue: No significant increase or decrease in reimbursement.
- Clinical: Having approximately the same number of candidates in these programs that you have today.
- Operational: No negative trends in KPIs and servicing metrics, e.g., first pass, pend rate, etc.
- Financial: Cumulative effect of the variance in the previous neutrality dimensions.
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