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


  1. Great suggestions! I enjoy reading your articles, Steve! Please keep up the excellent work. One additional suggestion for payers is to form an ICD-10 commuications steering committee consisting of sr. /exec management from across the organization tasked for feedback, buy-in, approval, etc. on ICD-10 communication initiatives. This will help ensure that there is a consistent message from the org and maybe the possibility to tie in with other communication efforts. Have a great weekend!

  2. Thanks Heidi...

    you have a good idea about a 'steering committee. A good friend of mine, Darryl Tucker, who started the "ICD Forum" group on LinkedIn, holds a regular "Roundtable" discussion where providers, payers and other interested parties get together and share ideas and needs related to ICD-10. It's local to the Portland, OR area but I think it's an idea that should be in use elsewhere.

    Happy weekend to you too!


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