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HIXNY ICD-10 Meeting April 16 th 1PM – 2:30pm

HIXNY ICD-10 Meeting April 16 th 1PM – 2:30pm. 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?

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HIXNY ICD-10 Meeting April 16 th 1PM – 2:30pm

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  1. HIXNY ICD-10 MeetingApril 16th1PM – 2:30pm

  2. 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

  3. HIXNY ICD-10 Collaborative Joe D’Allaird – Chair- SPHP Julie Brucker, RHIA – Co-Chair, Glens Falls Hospital Lynn Riley – Co- Chair, MVP Healthcare April 2014

  4. 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

  5. Members Continued • Fidelis Care Nathan Littauer • Glens Falls Hospital NYS Dept. of Health • HealthNow NYS Insurance Fund • HCFA Electronic Billing Oneida Healthcare • Inter-Lake Health Oswego Health • Legacy Consulting Post In Track • Lewis County General River Hospital • Massena Hospital Sampson Prostetic • MVP Healthcare Saratoga Care

  6. Members Continued • Seimens • St. Peter’s Health Partners • St. Josephs • Strategic Solutions • SUNY Upstate Medical • United Healthcare • US Oncology • Wellcare • Wellpoint

  7. Presentations To Group • 3M HIM Solutions (Grouper Readiness) • Post In Track • HANYS Solutions • Emdeon • SSI • Workmen’s Compensation • NGS/EDI –National Government Services

  8. 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

  9. 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

  10. 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

  11. ICD-10 Delay • On March 31, 2014, the US Senate passeda bill to delay the planned ICD-10 implementation until Oct. 1, 2015. 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.”

  12. 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?

  13. 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

  14. Payor Testing Dates w/ Test Date • eMedNY 10/1/2014 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-103/24/2014 Ready To Test • 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=6fa2600ae29fb210VgnVCM1000002f10b10a____ Q1 2014

  15. 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 24th was the deadline to get approval of testing site does anyone have approval? • What are members doing internally for continuing education? • Training plans - revised?

  16. 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?

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