Electronic Health Records

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AAFP: Major health plans told us they’re ICD-10 ready

By Jennifer Bresnick

The American Academy of Family Physicians (AAFP) isn’t leaving ICD-10 readiness up to chance.  After sending a list of preparedness questions to some of the biggest payers in the country, the professional society is sharing the good news: the health plans have all confirmed that they will be ready on their end to accept, adjudicate, and pay for claims submitted in ICD-10.

AAFP private sector advocacy strategist Laura Schmidt contacted big payers like United Healthcare, Aetna, BlueCross BlueShield, and Humana about their testing and readiness status.  While each payer has an ICD-10 status page available for providers, the industry has continued to have questions about how to prepare and if all business partners will meet the increasingly tight deadline.

Schmidt asked payers to confirm that their internal and external testing processes were either underway or complete, if the organizations had developed contingency plans and troubleshooting procedures, and if they will be providing opportunities for physicians to test their own claims processes.  The plans said that they will ensure readiness with their largest clients, hospitals and health systems, before turning their attention to individual physician practices and groups.

“Payers want this transition to run smoothly, too,” said Schmidt. “They’ve invested a lot of time and money into the ICD-10 implementation, just as family physicians have. The bottom line is that no business, big or small, involved in this effort can afford a slowdown in its billing and payment processes.”

With the private payer environment on track and Medicare claiming that it is more than ready to handle the transition without much further testing, the burden is now squarely on providers to shift into high gear.  Little more than six months remain until October 1, 2014, and many providers are still struggling to come to terms with all the work that still needs to be done.  CMS is offering an online training series for providers to help them prepare for the transition, even as HIMSS recommends that organizations don’t underestimate the effort still involved.

 

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