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Life after ICD-10 at Great Lakes Eye Care

Like most of the healthcare industry, Allscripts spent years preparing for the ICD-10 transition, which occurred on Oct. 1, 2015. Our Allscripts Payerpath® team monitored our systems and claims closely, and as anticipated, we did not see any issues related to ICD-10 in the days after the transition.

Our operations consultants reached out to Payerpath clients, including Shari Payne, CPC, Administrator for Great Lakes Eye Care (St. Joseph, Michigan, U.S.A.). On October 2, Payne responded with an email so enthusiastic, we just had to share:

We had ZERO errors today. We had a full house of patients, we did not decrease the schedule at all, and did not have ONE SINGLE ERROR. WAY beyond my biggest hopes!…Thank you so much for including us in your end-to-end user training…..what a benefit to us. We are all dancing the dance of joy today!

We followed up with Payne a few weeks later and learned that preparation was key to success at Great Lakes Eye Care. Here are highlights from that conversation:

How long did you prepare for the ICD-10 transition? What were your major concerns?

For two years. We believed it would go live a year ago, and we had to figure out how to educate our staff, including 10 physicians in three locations. We wanted to figure out how to do it without disrupting the doctors.

Our biggest concern was being able to get our claims out the door. We didn’t know what was going to happen with insurance carriers, and if claims were going to be accepted. That of course affects reimbursements coming back. And we had to get our heads around all these new codes.

What did you do to prepare for ICD-10?

We worked closely with Allscripts and partnered with White Plume, and the interface worked like magic. We built rules, used an electronic fee sheet and created our own drop down boxes based on our most frequently used codes from the past two years.

Next came training. We held a continuing education conference for all of our referring optometrists and their staffs – about 250 people attended. Once staff understood the theory and the system, we did our testing with Allscripts and it came out perfectly.

For an effort like this, I am so thankful we partnered with Allscripts Payerpath. I’ve never had an issue getting a call returned or getting the information we need. Of all the vendors we work with, Payerpath is at the top of my list. You make it so easy for us.

Describe October 1 – What happened that day?

I felt confident, but still really nervous. We use scribes to code in the rooms with the physicians, and we knew it would be more work to have so many codes to choose from. But it really was business as usual – our physicians never felt a thing, and that was my goal. I’d make my rounds, and it was as if nothing had happened.

How do you know the transition was successful?

We’ve had zero ICD-10 errors or claim denials. Our reimbursement checks have started coming in from payers with no errors. I never imagined we’d have zero errors; I’m so happy.

It’s important to recognize that extensive testing was key to this group’s success. Great Lakes Eye Care volunteered to test and (once qualified) enroll with the Medicare Administrative Contractor (MAC), which involved pre-selecting the patients for test claims to set up in the MAC’s test system. Once the test cycle started, the provider had to setup a Practice Management test database for ICD-10, identify high-impact diagnosis billing scenarios critical for the practice, correctly code between 20-25 quality test claims for the targeted scenarios, and submit the claims to Payerpath using a special upload test file process. Finally, the practice reviewed the payer response reports for any errors then review remittances for financial accuracy and reported findings to Payerpath.

Congratulations to Great Lakes Eye Care for having a solid, well-executed ICD-10 transition plan. Good preparation will position this organization for success now and into the future. For those organizations that still need assistance with ICD-10 strategies, contact us.

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