5010 Update

In April, I blogged that Clinicient was well on its way to addressing new 5010 requirements, If it is Spring it must be 5010 time.  As summer rolls around, I feel like it is appropriate to update our progress.

The latest release of Insight Billing completes our inclusion of 5010 requirements into production.  Our Errata testing is nearly complete and our only issue to date has been with two Medicare part-A intermediaries. This issue was a non-standard implementation of a field known as Admission Type and was easily addressed.

The total number of changes required to move from 4010 to 5010, specific to PT was not significant, and effective July 1, 2011 we will be able to send out all claim data in a native 5010 format.  We continue to monitor submission across the more than 2000 payers with which we interact, but expect a smooth transition between now and January 1, 2012.

Clinical Leadership

My tenure at Clinicient has afforded me a unique opportunity to observe the management of hundreds of physical, occupational and speech therapy practices all over the country.  These practices range from very small to very large and represent a wide variety clinical specialties.  I have come to the conclusion that the one thing that separates the super successful practices from the also-rans is one thing: Great Clinical Leadership.

ANSI 5010 and ICD-10

There are important changes coming in electronic insurance claims and diagnosis coding. The new standard for electronic claims is known as ANSI 5010 and it will be in effect on January 1, 2012. The standard diagnosis codes are changing from version ICD-9 to version ICD-10, effective October 1, 2013. We have been keeping abreast of all of the changes in these standards and working on the technical changes in our systems to prepare for the transition. We will continue to update all of our customers in this space as we get closer to these deadlines.

Meaningful Use of Health Information Technology

On December 30, 2009, CMS  and the Office of the National Coordinator for Health Information Technology released documents clarifying what physicians and hospitals must do to qualify for government incentive payments for the “meaningful use” of electronic health care records.  The standards for Stage 1 of the  meaningful use requirements were finalized on July 13^th, so physicians and hospitals are now eligible to qualify for the first round of incentive payments.  Outpatient rehabilitation organizations will not be eligible for the first round of incentive payments, and it is not clear when they might become eligible. Clinicient is monitoring of all of the developments in this area, and is well positioned to meet the eligibility requirements for outpatient rehabilitation facilities when and if that becomes a reality.

If You Can Measure It …

Every business can be reduced to a handful of numbers that can tell you at a high level how your business is performing. These key performance indicators become the guages on the dashboard of your business that can tell you when you need to pay special attention and potentially think aobut making changes. As the old saying goes, “if you can measure it, you can manage it.”  The first step in the process of business improvement is to identify the key performance indicators of your business and start measuring them regularly. Once you are measuring them, you can establish a baseline – a measure of where your business is today.