correct coding, claims appeals, prompt pay, and other insurance matters by contacting the TMA Billing and Coding Hotline. Call (800) 880-1300, ext. 1414, or (512) 370-1414, or visit the TMA website, www.texmed.org/hassle, for additional information about the Hassle Factor Log and the Billing and Coding Hotline.


MGMA: ICD-10 readiness lags


Medical Group Management Association (MGMA) research suggests the overall readiness of the health care industry to meet the Oct. 1, 2014, compliance date to adopt the ICD-10 coding system con- tinues to be slow. The greatest concern is the lack of communication and criti- cal coordination between physician prac- tices and their essential trading partners (such as claims clearinghouses, elec- tronic health record [EHR] vendors, and practice management system vendors) regarding software updates and testing, which has not yet occurred. Only 4.8 percent of practices reported that they have made significant progress when rating their overall readiness for ICD-10 implementation. The research in- cludes responses from more than 1,200 medical groups where more than 55,000 physicians practice. “The transition to ICD-10, with its substantial impact on documentation of clinical care, physician productivity, and practice reimbursement, is unprecedent- ed,” said Susan L. Turney, MD, MGMA president and chief executive officer. “It is proving to be one of the most complex and expensive changes our health care system has faced in decades. Adding to the implementation challenge and clear- ly taxing all stakeholders, ICD-10 will ar- rive at the same time that a number of other transformative federal policies go into effect, such as health insurance ex- changes and Stage 2 of the Centers for Medicare & Medicaid Services [CMS] meaningful use EHR incentive program.” CMS has mandated the ICD-10 diag-


60 TEXAS MEDICINE August 2013


nosis code set for use by physician prac- tices, other practitioners, clearinghouses, and health plans. The health care indus- try uses the ICD code set, developed by the World Health Organization, to iden- tify patients’ diseases, signs, symptoms, abnormal findings, complaints, and causes of injury or diseases. With ICD- 10 containing more than five times the number of codes as ICD-9 and incorpo- rating a completely different structure, the new code set will require extensive changes for medical groups. MGMA research highlights the follow- ing ICD-10 readiness findings:


• Lack of response from vendors. More than 52 percent of respondents indi- cated they had not heard from their practice management system vendor regarding when software changes would be available to the practice. Al- most 50 percent had not heard from their EHR vendor.


• Internal software testing lags. Only 5.9 percent of respondents reported that internal software testing has be- gun or is complete with their practice management software vendor and 4.7 percent with their EHR vendor.


• External testing delays. Just 11.9 per- cent of respondents reported external testing with their clearinghouse has started or is complete. Almost 60 percent reported they have not even heard from their clearinghouse re- garding a testing date. Only 8.6 per- cent have started or have completed testing with their major health plans, with a concerning 70 percent stating they have not heard from their major health plans.


• Low confidence for a successful tran- sition. Nearly 60 percent of respon- dents stated they are “slightly” or “not at all confident” their major health plans will be ready to meet the Oct.1, 2014, compliance date.


• Concern about changes to clinical documentation. Among a number of implementation concerns, 88 per- cent are concerned or very concerned about the expected changes to clini- cal documentation; 87.5 percent are concerned or very concerned about the loss of clinician productivity after


implementation; and 81.1 percent of respondents indicated they are con- cerned or very concerned with the overall cost of switching to ICD-10.


• Absorbing costs for transition. Only 32.5 percent of respondents report that their cost to upgrade or replace their practice management system software will be covered by their ven- dor. Only 37 percent say their vendor will cover the cost to upgrade or re- place their EHR.


• Cost of transition. For those organiza- tions that must cover the costs them- selves, the average cost for a 10-phy- sician practice to upgrade or replace their practice management system and EHR software to accommodate ICD-10 is $201,690.


The value of accepting credit cards


Collecting payments for services is a major challenge facing medical practices. One way practices are helping to address that is by accepting electronic payments, which are more efficient, reliable, and secure than paper-based payments. According to TMA Practice Consult- ing experts, more medical practices are choosing to accept Visa and other pay- ment cards from patients to pay for ser- vices because of the numerous benefits they receive, including streamlining pay- ment collection processes and helping to reduce administrative costs. This trend is expected to continue, as patients use cash and checks less and less and expect more convenient payment options and improved customer service as they be- gin paying for more health services out of pocket. TMA experts maintain that medical


practices that choose to accept payment cards receive numerous benefits that far outweigh the cost. If you’re concerned about the expense of payment cards, be aware that your ability to collect more money at the time of service and to spend less time and money on postser-


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