Assessing dual coding costs

Healthcare organizations will have to use both ICD-9 and ICD-10 for a considerable amount of time in 2014 in order to complete a successful transition to the new system.

Health IT vendors which support dual coding will be the ones who will stand out, although care providers may not be able to afford it.

Medical coders need to be trained for ICD-10 as well. However, they are not the only ones who require training. Physicians need to be trained on documenting correct ICD-10 code specificity. If this doesn’t happen, dual coding will not be beneficial in any way.time to plan

Dual coding is a way to test medical coders’ knowledge and documentation. However, the testing process must not be hampered by mistakes that could be addressed through awareness campaigns. Dual coding must be used to locate unforeseen problems which require time and money before it can begin.

Medical coding productivity is showing a 50% decrease in initial ICD-10 testing. This means that in the time required to process two test ICD-10 claims, coders should be able to process four real reimbursement claims. But it is not the case. Add to this the time spent to clarify queries from physicians and coders find themselves unable to prepare ICD-9 claims.

It really depends on a healthcare organization to do a cost-benefit analysis to see whether it needs extra medical coders to accommodate ICD-10 testing or is okay with longer reimbursement cycles. It is also important to realize that medical coders are not sure if they are using the right ICD-10 codes since the system is new for them as well.

The Hospital of the University of Pennsylvania has formed a team of 10 ICD-10 superusers to ensure coding accuracy. Each member uses the same records for coding and then all of them compare results with each other to discuss possible variances and the reasons for them. After the discussion, they reach a consensus on the correct ICD-10 codes required for the procedures and how they can unanimously agree to it.

But while it may sound great, it is adding more time and cost to the dual coding process. Compare this to the financial hit health organizations will have to take after October 1 if they are unprepared and it looks negligible.

It may be a good investment to allow medical coders to play with the ICD-10 system before the deadline to improve documentation. Care providers have real cases to test for ICD-10 through clearinghouses and payers and which will automatically tell them a lot about their HIT resources.

But once care providers have the much discussed ICD-10 data, what will they do with it? They can use it to add to internal medical research, assess financial impact, predict DRG shifts and reimbursements after the October 1, 2014 deadline.

Someone will have to invest time and resources in analyzing dual coding data. The Healthcare Information Management (HIM) department might be able to do that or consultants will be required for it. All of this time and money spent will be considered investments after October 1 but practices will not figure this out unless they start assessing dual coding costs right now.


Why cloud based EHR systems are better?

Healthcare providers all across the nation are shifting to modern Electronic Health Record (EHR) systems. Some of them are pure cloud-based while others are cloud enabled. True cloud EHR systems have remarkably reduced initial investments on hardware, hosting as well as for ongoing costs such as maintenance, upgrades, etc. Cloud EHR systems also improve accessibility; users can access the systems with just an internet browser from anywhere at any time and would enjoy more benefits then having a locally installed system.

Let’s discuss features of a cloud system.


When a medical organization needs more bandwidth than routine, a cloud-based service can instantly meet the demand because of the vast capacity of the vendor’s remote servers – something that is not possible with server-based systems.

Disaster recovery

When organizations rely on cloud services, they no longer need complicated disaster recovery plans. Cloud computing providers take care of most issues, and they do it faster. There is no need to maintain separate backups.

Automatic updates

Cloud-based EHR suppliers maintain servers and security updates themselves freeing up their customers’ time and resources for other tasks.

No capital investments

There is no need for capital expenditure at all when dealing with cloud-based EHR software. Since cloud systems are much faster to deploy, organizations have minimal project start-up costs and ongoing operating expenses.

Increased collaboration

Cloud computing EHRs increase collaboration by allowing all employees to sync up and work on documents and shared apps simultaneously. They can follow colleagues and records to receive critical updates in real time.


Nearly 800,000 laptops are lost each year in airports alone. This can have some serious monetary implications, but when everything is stored in the cloud, EHR data can still be accessed no matter what happens to a machine.

Scalability and speed

Health enterprises can quickly scale up or scale down their cloud services as per demand, during hours of maximum activity, while launching campaigns, etc. Cloud services are most usually reliable, since many service providers have data centers in multiple locations for keeping the processing near users.


New research on how to keep patients loyal

Keeping patients loyal is crucial. However, patient confidence in provider’s abilities and how the staff cares for them is critical to patient retention.

The two important indicators of patient loyalty to a medical practice are patient confidence in the provider along with quality of care coordination. These factors surpass other issues such as wait times, practice facilities and ease of access as revealed in a recent study by healthcare consulting firm Press Ganey.research

The study finds that growing amount of patient access to provider quality data could see more patients switching physicians. This will certainly be fuelled by the Affordable Care Act as patients will have more physician options to choose from.

Press Ganey highlighted five risk factors which could lead to patients switching providers. It developed an algorithm that can be used to benchmark the risk of losing patients and suggested steps practices could take to mitigate the risks.

The identified risk factors include:

  • Confidence in provider
  • Care coordination
  • Provider concern about patient queries
  • Listening
  • Courtesy

Press Ganey developed a Decision Tree Analysis in which patients with high or low degrees of risks for leaving their physicians were divided into groups. Patients with a 1.9% risk of changing practices had “high confidence” in their providers while those with a 75% risk had “low confidence”.

Patients who expressed high confidence in their providers and felt good care coordination had a 1% risk of leaving the practice while those who thought care coordination was not good, had an 11% risk of switching providers. Patients who lacked confidence in their providers but believed the practice was good at care coordination were at a 28% risk while those patients who did not have confidence in their providers and did not like care coordination had a 90% risk of switching practices. The same risk factor methodology was applied to the other three factors determining patient loyalty as well.

“This analysis suggests that coordination of care and demonstrating concern for the worries of patients represent key opportunities for physicians and their associated medical practices to improve patient care, while also enhancing patient loyalty and supporting financial viability,” the Press Ganey researchers say.


Global Healthcare Reform: The future of care

A recent study has found people being optimistic about advancing care though technology innovations, willing to participate in virtual visits and using sensors in their bodies and surprisingly, in their toilets as reform

Participants from eight countries were counting on technological innovations to cure fatal diseases – more than having additional physicians and research. The online survey had participants from Brazil, India, Indonesia, China, France, Italy, Japan and the United States with a sample size of 12,000 adults, aged 18 and above.

“This survey indicates very high willingness of people to become part of the solution to the world’s healthcare problems with the aid of all sorts of technologies,” Eric Dishman, Intel fellow and general manager of the company’s Health and Life Sciences Group, said in a news release. “Most people appear to embrace a future of healthcare that allows them to get care outside hospital walls, lets them anonymously share their information for better outcomes, and personalizes care all the way down to an individual’s specific genetic makeup.”

The research finds that people want personalized care based on their behaviors and biological characteristics in a setting of their choice.

Key findings include:

Improving personal care

  • More than 70% people are willing to use toilet sensors, prescription bottle sensors or swallowed monitors.
  • 66% respondents would prefer genetic profiles based personalized healthcare regiments.
  • 53% people would more likely trust a personally administered test than a physician.
  • 30% respondents would trust themselves to do their own ultrasound.

The results are surprising and reflect a monumental shift in patient preferences from traditional medicine to self care. It is amazing to see people trusting technology more than physicians and are inclined in taking control of their health.

Sharing personal health records

  • More people are willing to anonymously share their health records.
  • 76% respondents agreed to share their clinical information anonymously in order to help research.
  • Amongst the people most willing to share health information, respondents from India were more in number.

These findings mean people are trusting healthcare technology and are willing to help healthcare research. Countries with poor health facilities are preferring technology more for healthcare.

Increased in-home healthcare

  • 50% respondents would trust a video conference diagnosis with their physicians.
  • 72% people prefer to connect online with their physicians.
  • 43% people would trust themselves to take their vitals.
  • 57% respondents said hospitals would become obsolete in the future.

The findings mean that high-performance computing and big data analytics have the power to transform care as we see it now. People prefer taking control of their health. They want care to be delivered in their homes and not in a hospital or clinic.


UnitedHealthcare handed injunction by Federal judge

A Federal judge has ordered a temporary injunction against UnitedHealthcare based on the case filed by two Connecticut-based medical associations.

The decision came hours before the health insurer was set to drop thousands of physicians and patients from its rolls. This injunction prevented UnitedHealthcare from removing any of the doctors until the court can rule on the merits of the case.

US District Court Judge Stefan Underhill ruled Friday, December 6, that the Hartford County Medical Association and Fairfield County Medical Association have “met their burden of demonstrating that they will suffer harm that is imminent and cannot be adequately compensated through damages.”

The two medical associations from Connecticut were seeking a temporary restraining order against UnitedHealthcare to prevent the insurer from removing nearly 20% physicians on the panel from its Medicare Advantage networks. If it had gone ahead with its plans, nearly 30,000 patients would have been affected.

The court order means that UnitedHealthcare will have to start proceedings from the beginning. However, the insurer maintains that it plans to immediately appeal against the decision.

“We believe the court’s ruling will create unnecessary and harmful confusion and disruption to Medicare beneficiaries in Connecticut,” says Terry O’Hara, of UnitedHealthcare Group, in an emailed statement. “We know that these changes can be concerning for some doctors and customers, and supporting our customers is our highest priority. United Healthcare will continue to stay focused on the people we serve.”

This ruling will only affect members of Hartford County Medical and Fairfield County Medical associations. The affected physicians, more than 2,200 in number, reportedly belong to Hartford, New Haven and New London counties.

The judge ruled that UnitedHealthcare appears to have breached its contract with the physicians by removing them without cause or explanation, causing a violation of Medicare regulations.

For the time being, the injunction stays and only time will tell how this will shape up in the days to come.

Choosing a Medical Billing Service