Agenda Plans going forward with delay in ICD-10 Implementation Update – Iroquois CFO Meeting WEDI ICD-10 Collaboration - Updates Carol McDonald – AMC Lynne Riley – MVP Testing Update Testing – any feedback from current plans/providers? NEXT STEPS Next Meeting : May 21, 2014 Presentation – Other presenters….. ?SPARCS
MEMBERS Albany Medical Center Community Care Phy. Albany Gastrointestional Cortland Regional Med Anthem CSC Auburn Hospital Elizabethtown Comm Blue Shield of Northeast NY Ellis Medicine Cayuga Medical Center Emblem Health CDPHP Emdeon Columbia Memorial Hospital Excellus
Members Continued Fidelis CareNathan Littauer Glens Falls HospitalNYS Dept. of Health HealthNowNYS Insurance Fund HCFA Electronic BillingOneida Healthcare Inter-Lake HealthOswego Health Legacy ConsultingPost In Track Lewis County GeneralRiver Hospital Massena HospitalSampson Prostetic MVP HealthcareSaratoga Care
Members Continued Seimens St. Peter’s Health Partners St. Josephs Strategic Solutions SUNY Upstate Medical United Healthcare US Oncology Wellcare Wellpoint
Presentations To Group 3M HIM Solutions (Grouper Readiness) Post In Track HANYS Solutions Emdeon SSI Workmen’s Compensation NGS/EDI –National Government Services
Projects Conducted Survey ICD-10 Readiness Within Group Survey ICD-10 Education Needs Testing timeline for all entities Sharing testing results – ongoing ▫CMS national testing day February 2014 Iroquois Website Functional Group members on WEDI ICD-10 Collaborative Sharing Results
Concerns Addressed Approach to Coordinated Testing Share experiences Clearinghouse/vendor issues –willing to test with all plans Process to resolve issues Authorization process during testing will it be bypassed Turnaround time for testing response Future Date concerns with testing
Concerns Address – continued CMS – NCD/LCD review (April 2014) Expectations of Provider/Payors on results of testing, what are each expecting after testing Number of claims that can be tested at a time Clearinghouses not planning to test with all plans they exchange 837’s with Testing for outsourced functions Top Specialty and high volume cases
ICD-10 Delay On March 31, 2014, the US Senate passed a bill to delay the planned ICD-10 implementation until Oct. 1, 2015.a bill http://www.cms.gov/Medicare/Coding/ICD10/ With enactment of the Protecting Access to Medicare Act of 2014, CMS is examining the implications of the ICD-10 provision and will provide guidance to providers and stakeholders soon. This provision in the statute reads as follows: “The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD-10 code sets as the standard for codes sets under section 1173 (c) of the Social Security Act (42 U.S.C. 1320d-2 (c)) and section 162.1002 of title 45, Code of Federal Regulations.”
Going Forward With Delay Continue with Testing Plans Continue with System Remediation Continue Dual Coding and Claims Review with ICD-10 Scenarios Continue to Meet and Discuss Testing Results ▫Meet less often but not stop! Questions?
Provider Testing Dates Glens Falls Hospital 2/1/2014 ▫Emedon NOW - plan for GE testing June 2014 Oswego Hospital 2/1/2014 Emdeon Nathan Littauer Hospital 3/1/2014 Tested with CMS, CDPHP in April, then Fidelis afterwards
Payor Testing Dates w/ Test Date eMedNY 10/1/2014 https://www.emedny.org/icd/index.aspx 7/28/2014 https://www.emedny.org/icd/index.aspx 7/28/2014 CDPHP 9/1/2013 http://www.cdphp.com/en/Providers/Get-Your-Job- Done/ICD-10 3/24/2014 Ready To Test http://www.cdphp.com/en/Providers/Get-Your-Job- Done/ICD-10 MVP Healthcare 2/1/2014 http://www.mvphealthcare.com/provider/ICD- 10_updates_and_faqs.html Ready Now United Healthcare TBD https://www.unitedhealthcareonline.com/b2c/CmaAction.do?channelId=6fa2600ae 29fb210VgnVCM1000002f10b10a ____ Q1 2014 https://www.unitedhealthcareonline.com/b2c/CmaAction.do?channelId=6fa2600ae 29fb210VgnVCM1000002f10b10a ____
HIXNY Members How Do We Move Forward? Are testing dates provided going to stay the same? Are providers moving forward with testing with CMS in July? March 24 th was the deadline to get approval of testing site does anyone have approval? What are members doing internally for continuing education? Training plans - revised?
Continue – Plans Going Forward Issues members are having with delay? Vendor Contracts Education software Outsource Contracts Provider Education Suggestions on meeting schedule – continue with monthly meetings until May 2014 – take the summer off? Or Switch to bi-monthly meetings?