Without a comprehensive risk mitigation strategy, the transition to the ICD-10 codeset has the potential to drastically affect the smooth flow of claims processing and reimbursement. Most of the news about this transition has focused on healthcare IT systems not being ready. But what about the providers? There is always risk in any major transformation. Managing it is the key to a successful implementation.
Once of the five greatest ICD-10 mitigation risks identified by Healthcare Information and Management System Society (HIMSS) is the possible effect on provider payments. But how does an increase in paper claims submission to a payer put provider payments at risk? There should be no difference if a claim is submitted electronically or on paper; they both are paid the same amount.
While that is true, the "process" of how paper claims are adjudicated is different than that of electronic claims. This particular risk has internal and external factors because it affects both the provider and the payer.
Download Full Whitepaper: ICD-10 Adoption May Increase Paper Claims and Healthcare Providers' Costs.