Provides recommendations to mitigate disruption in claims processing after Oct. 1
The Workgroup for Electronic Data Interchange (WEDI), the nation’s leading nonprofit authority on the use of health IT to create efficiencies in healthcare information exchange, announced the release of its findings from its June 2015 ICD-10 Industry Readiness Survey. In August letters to the Health and Human Services (HHS) Secretary, WEDI shared survey results and recommendations, strongly encouraging the department to continue to leverage its communication channels to promote the need for compliance because of the impact that non-compliance could have on the industry.
“While much of the industry is nearing readiness, nearly one-quarter of physician practice respondents said they will not be ready by the October 1, 2015 deadline and another one-quarter were unsure,” said Jim Daley, WEDI past-chair and ICD-10 Workgroup co-chair. “Without a dedicated and aggressive effort to complete implementation activities in the time remaining, this lack of readiness may lead to disruption in claims processing.”
In its commitment to the industry, WEDI has produced many work products and tools to ensure a smooth transition to ICD-10 and these ongoing surveys have been designed to gauge stakeholder readiness. Highlights from the latest survey findings include:
- Physician practice testing and readiness: Only about 20 percent of physician practices have started or completed external testing and less than 50 percent responded that they were ready or would be ready for Oct. 1. This is cause for concern.
- Hospital/health system testing and readiness: Almost 75 percent of hospitals and health systems have started or completed external testing. Additionally, nearly 90 percent responded that they were ready or would be ready by the compliance date, while a few were unsure if they would be ready.
- Health plan testing and readiness: Nearly 75 percent of health plans have begun or completed external testing. 40 percent responded that they were already prepared and the remaining 60 percent said they would be ready by October 1.
- Vendor product development and availability: 75 percent of vendor respondents have fully completed product development and no one responded that their products would not be ready by the compliance date.
WEDI recommendations to HHS included the following:
- HHS should expeditiously provide full transparency regarding the readiness of individual Medicaid agencies by state.
- The recently-announced Ombudsman position should be appointed as soon as possible and WEDI strongly urges CMS to not wait until the compliance deadline to complete this appointment.
- The go-live ICD-10 support plan should include leveraging WEDI’s and CMS’ implementation support program, which already serves as the central source for collecting ICD-10 industry issues and solutions.
- Additional outreach is needed in order to help providers with complying with most recent local coverage determination codes (LCDs).
“It is critical to closely monitor industry progress and testing as we approach the compliance date to gauge what might occur on Oct. 1, 2015,” said Jean P. Narcisi, chair of WEDI. “In light of our most recent findings, we are hopeful that industry leaders take the necessary steps to help ensure that the transition to ICD-10 is completed with minimal disruption to the healthcare industry.”
About the Survey
The survey results are based on responses from 621 respondents, consisting of 453 providers, 72 vendors and 96 health plans.
This is the eleventh ICD-10 readiness survey WEDI has conducted since 2009, all of which were done in an effort to gain a broad perspective on the readiness status for different sections of the industry, and to gauge how quickly they are progressing towards the Oct. 1, 2015 implementation deadline. More information on WEDI events and ICD-10 work products are also available on the WEDI website at www.wedi.org/workgroups/icd-10.
About WEDI
The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency, and reduce costs of our nation’s healthcare system. WEDI was formed in 1991 by the Secretary of Health and Human Services (HHS) and was designated in the 1996 HIPAA legislation as an advisor to HHS. WEDI’s membership includes a broad coalition of organizations, including: hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations, and standards development organizations. To learn more, visit www.wedi.org and connect with us on Twitter, Facebook and LinkedIn.