Healthcare Entities Largely Unprepared for ICD-10 Implementation: KPMG Survey

From GlobeNewswire

According to a recent survey performed by accounting firm KPMG, most healthcare entities are unprepared for the coming ICD-10 changeover.

From the original article:

“The KPMG poll, conducted from October to December of 2013, found that while the majority of payer and provider respondents acknowledged that they had completed an ICD-10 impact assessment (76 percent) and had allocated budget toward readiness efforts (72 percent), they were significantly deficient in preparing for key aspects of implementation. Comprehensive system testing, determination of impact on cash flow and revenue cycles were where the majority of respondents revealed that their respective organizations had not properly addressed the impact of ICD-10 implementation.”

This is something that should be of concern to all involved.  Nearly half of the respondents to the survey felt that there would be a significant increase in denials due to the change over.

From the original article:

“In terms of specific processes, nearly half of those surveyed (45 percent) believed that denial/variance management would be most affected in the transition outside of coding and documentation,” added Randy Notes, a principal in KPMG’s Healthcare & Life Sciences practice who specializes in revenue cycle operations and improvement. “Successfully managing denials and variance entails a thorough analysis of not just the new codes, but reviewing trends of the previous ICD-9 codes and mapping high volume medical necessity. Organizations also must familiarize themselves with claims rejections and denial representatives under the new process and designing a brand new billing process. It is easy to see why this was a leading pain point among our field.”

One of the issues is that many entities will wait to the last minute to perform their changeover and testing. This will help increase chances of errors and running out of time. Healthcare entities are being encouraged to begin testing now and have their staff trained to be ready for the changeover that is just months away.



Share this post:

Leave a Reply

Your email address will not be published. Required fields are marked *