Thursday, December 29, 2011

How Might Health Care Payers Help Providers Toward ICD-10 Compliance?

Based on several  survey’s I’ve read - and some statements made from  the MGMA and the AMA (Click here for MGMA & AMA Stance on ICD-10), it seems it’d be good for health plans and the CMS to take on a more active role in helping some providers get their arms around ICD-10 compliance. 
Static content is good; and yet consider how simple target market analytics, some active contact like creative video, engaging audio, occasional reach out and semi-customized content could be leveraged to attract and assist qualified provider eyeballs, ears and brains.  Face time will follow and should surely benefit.  No? are some of ideas I have as to how health care payers like group health plans and the CMS might be able to help their health care providers get a move on their ICD-10 compliance:
1.          Identify the smallest, "large" providers – by total payment and transaction volume; show them some special attention. Take an 80/20 approach. (Forget the Huge Providers...If they're behind, let 'em fail.  They're prolly big enough)

2.          Survey more and more providers as to their ICD-10 readiness and how they can be helped.  What do they need? What are their major concerns? Take note of those who're making progress and who state they're doingok. And follow-up with those who respond with requests for assistance. But put non-responders on a list for special attention later on.

3.          Continue outreach efforts to all providers and inquire about their ICD-10 readiness.  Make them aware about your interest in assisting them.

4.          Educate provider representatives and provider support staff so as to leverage existing provider relationships and each provider touch-point/opportunity.

5.          Post ICD-10 information and conversion status/progress details important to your providers on your web site, your newsletters, your EOB’s, your IVR call tree, rent a digital billboard down by the Mercedes dealer, etc. (ok…maybe the Nissan dealer…)

6.          Consider holding information sharing seminars and/or adding some ICD-10 awareness training to other regularly distributed provider communication materials.

7.          Use creative ways to educate your providers about ICD-10:
a.          Add short, to-the-point updates to ‘on hold’ messages played on your provider support line. Update them on a period basis and don’t bore your listeners. Variety!  Variety!

b.         Add a click-through page and/or other links about ICD-10 on your provider portal.

c.          Offer your providers some free or low-cost ICD10 awareness and education/training.

d.         Call the spouses of your providers and/or their office administrators – inform them their 2014 summer vacation and/or juniors college tuition could be at stake if they don’t get in line.

e.         Consider modifying your provider inquiry channels to route ICD-related calls to resources most qualified to resolve their needs.
What do you think about these ideas?  What else do you think may help? Let me know what else you want to know.  Ask me a question here and I’ll do my best to respond: Tell me what you want to know about ICD-10
Steve ‘ShimCode’ Sisko

Tuesday, December 27, 2011

Validating and Verifying Your ICD-10 Remediation Efforts

When planning ICD-10 remediation efforts, forward thinking organizations may want to work backwards: and think about and plan early on about how they’ll verify and validate their remediated software, processes and procedures.
Here are a few ideas to chew on:
1.     Identify major cutover and testing issues likely to impact core business processes; make sure your business and IT teams appreciate their meaning and possible impact to their respective areas of responsibility (AOR’s).
2.     Identify and engage all stakeholders – internal and external - with development of test strategies impacting their AOR’s.

3.     Query key business and IT leaders as to their level of comfort and ability to stand up to and meet their obligations.  Including the following:

a.     Do they have a good understanding of the existing processes that will be impacted by ICD-10?

b.     What  concerns do they have regarding their remediation knowledge and their control of sufficient resources to perform adequate ICD-10 testing while continuing to meet existing production and other non-ICD-10 obligations?

c.     Decide how to best support those who indicate they might have trouble meeting these dual obligations. i.e. maintaining the current “as-is” while assisting with and ensuring their ability to meet the future “to-be.” 

4.     Periodically reconnect with those who initially indicate their ability to meet their ICD-10 obligations while maintaining their current operational duties.  It’s often easy to say “all systems are go” yet come back later asking for more time and money.  IMO, it’s against human nature to say you’re not sure about the unknown. Things change; shit happens.

5.     Identify contingency plans to assist those who may become resource-constrained in the 11th hour.  Or better yet at 14:30.

6.     Consider using external resources to test your most critical processes.

What else do you want to know about ICD-10? Take this survey and tell me.  I’ll share what I think.

Happy New Year!


Monday, December 12, 2011

Hey Payers & Providers! What do you want to know about ICD-10?

Happy Holidays! 

Like most people this time of year, I'm in the spirit of sharing my wealth - so please help me decide how to best share my wealth of ICD-10 knowledge, experience and time.  Take the following survey to help me where I can do the most for the most.

What do you want to know about ICD-10?

Two weeks from today I'll tally the results and offer up information on the most popular topics. And I'll share all survey responses with those who provide me with contact information.

Happy Holidays! And God Bless Everyone!

Steve 'ShimCode' Sisko