What Grace Period

The commercial carriers are finally answering the question about ICD-10 conversion. There will not be a grace period. According to Doctors’ Management, Aetna and United Health Care have both said they will not offer a grace period and all their claims processing rules are still in effect. A number of Blue Cross products have stated that they will not offer a grace period either. The only company that has said they will offer a grace period is Humana at this point. I confirmed with Texas Medicaid today that their Transmittal on September 8, 2015 does is in fact the final word that all ICD-10 codes are expected to be at the highest level of specificity.

Remember the transition to 5010? Many practices had payments delayed as carriers experienced new problems with their software as the volume of claims submission increased. How many times have you seen a upgrade of this magnitude that did not experience problems as the volume increased. The only question will be which carrier’s software will fail first. There are also going to be carriers that are just not ready yet so they have to make some arrangement with another carrier of clearinghouse to handle their claims until the software works.

In Canada when they made the transition ICD-10 they experienced a large learning curve and loss in productivity. One hospital said that the average coding time per record went from 12-15 minutes to 33 minutes, and turnaround time increased from 69 days to 139 days. You can expect that most practices will see this slow down for as long as 6 months.

There are still many small providers that are not prepared for this transition and could go out of business with a dramatic slow down in claims. We will keep updating this information here on our website as we get additional information.

You can go to www.doctors-management.com to register and see a copy of the September news letter. You can also join us on Linked In for latest updates.