One of the biggest challenges facing the industry ahead of ICD-10 is coordination among tens or hundreds of business partners. Providers, payers, and vendors all need to be on the same page at the same point, and yet the struggle to synchronize and streamline everyone’s efforts seems to be causing significant anxiety leading up to October 1, 2014. Providers have the most to lose from the lack of vendor readiness, since it’s their revenue that stands to suffer. Here are ten questions you should be asking your vendor in the run-up to implementation.
Who is my dedicated contact person?
You can’t ask good questions if you don’t have someone to talk to. Find a point person you can speak to directly, and make sure he or she is high enough in the organization to give you meaningful answers in a timely manner.
When will your ICD-10 compliant system be ready?
Vendors are falling behind the curve when it comes to developing and releasing their products in time for thorough testing. In a recent WEDI survey, 20% of vendors indicated that their ICD-10 compliant products wouldn’t even be ready for beta testing until 2014, which puts the squeeze on provider timelines. Try to get a firm answer from your vendor about product release dates so you can plan your own efforts accordingly.
Are there any additional costs involved for upgrades or ongoing maintenance?
Some vendors are simply issuing software upgrades, while others are producing an entirely new version of EHR, practice management, or coding products. You need to know if they’re planning to make you pay for new software updates, and how much they’re expecting from your ICD-10 budget.
Are there new hardware requirements on my end?
Software upgrades often require the latest and greatest in IT infrastructure. It’s important to be clear about what your hardware capabilities are, and if your systems are adequate to run new versions of your vendor’s products. You may be in for some costly purchases if you’re still using Windows 95.
Will there be new things to learn within the software interface?
ICD-10 will bring an onslaught of changes to the clinical and administrative workflow. If your EHR or practice management interface is changing, too, your staff needs to know. Think of how difficult it was to adjust to an EHR workflow in the first place. Now think about having to re-train on that software, but with the added documentation specificity requirements, new templates, confused coders, and frustrated staff. You may need to build in extra training time if your software will be significantly different.
What customer support and training will be provided?
Some vendors might provide training for their new ICD-10 features, and some might not. Some might even charge extra for these services, so be prepared. If customer support is lacking, or training is skimpy at best, it’s better to know well in advance that your organization will be the one picking up the slack.
What is the basis of your crosswalk or mapping strategy?
GEMs are all very well and good, but they have limited utility as a crosswalking platform. You need to make sure that your vendor truly understands the challenges of translating ICD-9 into ICD-10 before you get bogged down in an insufficient product. “A practice management vendor told me earlier this year that they were ready for ICD-10 in the US because they downloaded ICD-10 from the World Health Organization (WHO) website rather than using ICD-10 CM and ICD-10 PCS,” recalls Sue Bowman, MJ, RHIA, CCS of AHIMA. Don’t let a similar lack of understanding leave you in the lurch.
Will your product support dual coding?
Many hospitals are planning to forgo dual coding, which gives coders time to practice and gain confidence with ICD-10 before being forced to use the new code set exclusively. If you do plan to include dual coding in your implementation plan, however, be sure that your vendor supports it. With 66% of providers unsure if their vendors are planning to include the feature, it’s important to establish whether or not you’ll even have the capability, let alone the time and manpower.
What is your external testing strategy?
External testing is a critical part of the ICD-10 conversion process, and a key factor in ensuring that revenue will continue to flow after October 1. Although CMS has controversially announced that they will not be conducting external testing on a large scale, you can still make sure that your software works. Find out when and how your vendors plan to test their products, and be certain that your organization is on the schedule. Catching problems before they start affecting your bottom line will save you some headaches in the fall of 2014.
Do you have a contingency plan if you’re not ready by October 2014?
There’s a good chance that you will end up asking this question in a very urgent tone of voice. With the industry scrambling to reach ICD-10 benchmarks, and a pervasive air of uncertainty coloring the preparation period, you don’t want to wait until September to get an answer. Vendors might not want to admit to their clients that they don’t have everything under control, but in order to make your own emergency readiness plans, you need to be aware of what your business partners are thinking.