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The True Cost of Transitioning to ICD-10: Infographic

Health Insurance Companies Process 1 in 5 Claims Wrong

The True Cost of ICD-10 Implementation
Did It Really Cost Your Medical Practice $50,000+?

From the beginning, ICD-10 has gotten a bad rap.

Whether it was fear from the massive jump in diagnosis codes or the expenses we were told would be necessary in order to make a successful transition, it’s been pegged as an intimidating process from the get-go.

Now, nearly three months into it, things aren’t looking quite so bleak.

This infographic from Ghergich & Co mentions some of the biggest concerns the industry had heading into ICD-10. We’ll discuss a couple of those below and how we – and our clients – have fared post-implementation.

Cost of Conversion

There were a wide range of cost estimates floating around prior to transition – most completely overwhelming, especially for independent practices.

The costs included all sorts of potential expenses, including employee training, infrastructure updates, and back-end testing. Rand Corporation estimated it would cost the healthcare industry between $475 billion and $1.5 billion over a ten-year period.

Broken down further, a 2014 study conducted by Nachimson Advisors LLC on behalf of the American Medical Association estimated the total implementation costs would be between $56,639 and $226,105 for a small practice. A large practice was looking at minimal expenses of around $2 million.

ICD-10-Impementation

Revenue Concerns

Loss of productivity was also a very real concern heading into ICD-10. So much so, that is was strongly suggested medical practices have financial reserves of six months to one year.

With the training that would be needed for virtually everyone in the practice – physicians, clinical staff, billers and coders – experts expected the entire billing process would be substantially slower.

Some of the early implementation issues that providers feared would lead to lowered or delayed revenues were:

  • Incomplete or unclear documentation causing unbilled claims to pile up
  • Increased rejected claims, either by CMS or clearinghouses
  • Delays in CMS payment due to system issues

CMS identified those concerns prior to implementation though, and acknowledged them by instituting a four-step plan to minimize payment delays and rejections.

The Reality

In reality, ICD-10 hasn’t been the costly endeavor it was originally expected to be. In fact, the transition has been very smooth for us at Capture Billing.

Our total conversion costs were negligible also – nowhere near the predictions of $50,000+. Instead, they aligned more closely with the estimates found in this Journal of AHIMA study.

We haven’t noticed any substantial productivity loss or payment disruption either. Sure, we were a bit slow in the beginning, but like anything else, we just needed a few weeks to get in the groove.

While it most definitely required effort and foresight on our end, the training, testing, and adjustments haven’t been burdensome. The doom and gloom that so many predicted never materialized.

Thankfully, the thorough preparation by our team at Capture Billing has allowed our clients to enjoy similar outcomes. Their claims are going out and reimbursements are flowing in.

Click to Enlarge Image

The True Costs of Transitioning to ICD-10

How did ICD-10 implementation go for you? Was it as expensive and difficult as predicted? Please tell me in the comments below!

 

is a 20 year veteran of healthcare having managed medical practices. He advises medical practices, physicians and practice administrators on how to run their practice and manage their medical billing and revenue cycle management. Manny speaks, blogs and makes videos at www.CaptureBilling.com, a blog that is tops in the medical billing and coding field. READ MORE

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Capture Billing helps medical practices by reducing their insurance accounts receivable and getting claims paid faster, allowing doctors to focus on providing quality healthcare to their patients without the stress of doing their own medical billing.

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The analysis of any medical billing or coding question is dependent on numerous specific facts -- including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies (as well as coding itself) are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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