ICD-10 Implementation, Consulting, and Conversion

ICD-10 Implementation, Consulting, and Conversion programs have changed since the first projects started in 2009.  For providers, in 2013 and 2014 we forecast more ICD-10 implementation consulting programs focused on first understanding the ICD-9 claims history via an ICD-10 financial risk assessment including ICD-10 analytics and ICD-10 clinical documentation via a chart review.  The implementation consulting effort for ICD-10 today must rely on tighter constraints.

Fast Start ICD-10

We started developing programs over five years ago in 2008 for health plans and providers.  When we set out to build our programs, we developed ICD-10 conversion plans that would include both internal claims and EDI infrastructure as well as contracted hospital facilities and physician practices. Though it seemed simple, this would not be easy because there are multiple systems and processes in the service chain between payors and providers.  We set out to build the best solutions in the industry, blending people, technology and a mix of payor– and provider–experienced consultants.

ICD-10 Continuing Education (CEU) and ICD-10 Continuing Medical Education (CME)

There are many facets to prioritize.  The types of training, executive leadership, board members, IT and operations staff, physician specialties, need training customized to their relevant role in the ICD-10 transition, timing of the training, who will train, and how training will be delivered, are factors.  We blend these considerations and deliver training to suit your needs including:

  1. ICD-10 physician specialty training (delivered at schedules to suit the physician schedule, on-site)
  2. Specific coder training whether inpatient, outpatient, or professional fee related
  3. Customized training addressing ICD-10 from a financial, IT, HIM, claims and billing team perspective
  4. Project governance training, largely overlooked by ICD-10 consulting teams and clients

We can deliver training via several modalities including:

  1. ICD-10 pre-recorded online training
  2. Live training via the web designed for interaction with the ICD-10 transition team
  3. On-site training by physicians, for physicians who need to know how their clinical documentation to support ICD-10

Rely on a Team that has the most ICD-10 Industry Experience to Answer Hard Questions

Our ICD-10 consulting team has trained over 700 providers and performed the first ICD-10 assessment in the country.  Our team can help determine how to customize the approach for your organization.  We look at several factors and help you answer key questions to do this:

  1. What will happen if I we do not start our preparation process for ICD-10 now?
  2. How do you set up a governance plan for ICD-10 with a communication plan to ensure the team knows who to go to for answers?
  3. What is the sense of urgency around ICD-10 implementation?
  4. What is the financial and reimbursement impact of ICD-10?
  5. How do we prioritize what should be done now for ICD-10 and what we can defer in our preparation?
  6. Which team members need training and how much ICD-10 training is right for each functional area?

 ICD-10 Consulting Capabilities – How to Start

Our team can build the governance structure to empower your internal team while setting up the subject matter expertise your organization needs.   We can help build ICD-10 work plans and timelines for each functional area of the organization.

Consulting, Implementation and ICD-10 Clinical Documentation Qualifications

No World Borders team of ICD-10 consulting experts are committed to consistently providing HIPAA Covered Entities whether health plan, hospital system, physician group, clearing house, or Health IT firm with the best ICD-10 Implementation, clinical documentation improvement, process improvement, IT systems assessment transition planning, ICD-10 double coding support, and training in the industry. We provide ICD-10 coding for hospital inpatient, ICD-10 coding for hospital outpatient, and ICD-10 coding for ICD-10 CM professional fees with CPT coding.  Our  industry leading team are certified by AAPC and AHIMA and ensure reduced reimbursement risk by blending this approach with analytics to narrow the amount of expensive manual processes to a focused group of physicians who represent the best time and financial investment for your valuable time and resources.

 

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Michael F. Arrigo

Michael is Managing Partner & CEO of No World Borders, a leading healthcare management and IT consulting firm. He serves as an expert witness in Federal and State Court and was recently ruled as an expert by a 9th Circuit Federal Judge. He serves as a patent expert witness on intellectual property disputes, both as a Technical Expert and a Damages expert. His vision for the firm is to continue acquisition of skills and technology that support the intersection of clinical data and administrative health data where the eligibility for medically necessary care is determined. He leads a team that provides litigation consulting as well as advisory regarding medical coding, medical billing, medical bill review and HIPAA Privacy and Security best practices for healthcare clients, Meaningful Use of Electronic Health Records. He advises legal teams as an expert witness in HIPAA Privacy and Security, medical coding and billing and usual and customary cost of care, the Affordable Care Act and benefits enrollment, white collar crime, False Claims Act, Anti-Kickback, Stark Law, physician compensation, Insurance bad faith, payor-provider disputes, ERISA plan-third-party administrator disputes, third-party liability, and the Medicare Secondary Payer Act (MSPA) MMSEA Section 111 reporting. He uses these skills in disputes regarding the valuation of pharmaceuticals and drug costs and in the review and audit of pain management and opioid prescribers under state Standards and the Controlled Substances Act. He consults to venture capital and private equity firms on mHealth, Cloud Computing in Healthcare, and Software as a Service. He advises ERISA self-insured employers on cost of care and regulations. Arrigo was recently retained by the U.S. Department of Justice (DOJ) regarding a significant false claims act investigation. He has provided opinions on over $1 billion in health care claims and due diligence on over $8 billion in healthcare mergers and acquisitions. Education: UC Irvine - Economics and Computer Science, University of Southern California - Business, studies at Stanford Medical School - Biomedical Informatics, studies at Harvard Medical School - Bioethics. Trained in over 10 medical specialties in medical billing and coding. Trained by U.S. Patent and Trademark Office (USPTO) and PTAB Judges on patent statutes, rules and case law (as a non-attorney to better advise clients on Technical and Damages aspects of patent construction and claims). Mr. Arrigo has been interviewed quoted in the Wall Street Journal, New York Times, and National Public Radio, Fortune, KNX 1070 Radio, Kaiser Health News, NBC Television News, The Capitol Forum and other media outlets. See https://www.noworldborders.com/news/ and https://www.noworldborders.com/clients/ for more about the company.