Barring any unforeseen circumstances, the U.S. healthcare industry will transition to the ICD-10 set of billing codes in less than three months.
As the countdown to Oct. 1 draws to an end, Fred DiLuzio, PhD, ICD-10 program manager for Hoag Memorial Hospital Presbyterian in Newport Beach, Calif., and Michael Roach, director of the program management office at Hoag Memorial Hospital Presbyterian, outlined the following five enterprise risk management focus areas for hospitals and health systems to address to help final preparations for the transition date.
1. Sustainability. Keeping the focus and engagement of ICD-10 teams can be critical, especially as some may tend to shift focus to the next big initiative appearing on the horizon. "If this occurs, remind your stakeholders what's at stake should your organization fail to be fully prepared," the authors write. They suggest considering incentives for key project members such as bonuses or opportunities to work on other prized assignments. While some turnover and attrition is natural, the authors reiterate the importance of sustaining ICD-10 expertise through the post implementation period.
2. Engagement. Engaging key stakeholders and project teams goes beyond holding team meetings and reviews. By reaching out to these individuals, healthcare leaders can make sure they are focused on tasks and preparations as well as discover any issues and concerns that may have been overlooked in formal meetings.
3. Connection. Before the transition date, the authors suggest providers increase the frequency with which they communicate with payers, especially the smaller insurers that may not yet be fully prepared to transition. "Consider as a condition of success a pre-cutover agreement to contractually require a specific percentage payment pending resolution of claims status within a specified date range," the authors suggest.
4. Practice. Conducting mock scenarios can help develop and establish protocol and responses to potential issues following Oct. 1. The authors suggest business leaders conduct these trial runs instead of project teams, as it frames responses in a real business scenario and also helps business stakeholders identify their roles and responsibilities in the ICD-10 program.
5. Bonding. Create a log of all contacts who may need to be contacted for remediation issues following the go-live data and their specific information. This includes, payers, vendors, clearing houses and any other entity related to ICD-10 or whose data transfers through your organization.
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