Home Health & Hospice Week

Are you going to hit a huge payment slowdown when ICD-10 takes effect Oct. 1? That’s what health care provider representatives are worried about.

CMS’s end-to-end testing periods have revealed claim acceptance rates in the 76 to 89 percent range, noted 100 provider groups, including the American Medical Association, in a recent letter to Acting CMS Administrator Andrew Slavitt. This range clashes significantly with the current standard Medicare acceptance rate of 95 to 98 percent, the letter stated. Because only a small number of providers participated in the testing, the groups worry that when all providers start submitting claims, that percentage rate will extrapolate out to the community at large, triggering massive denials.

“The likelihood that Medicare will reject nearly one in five of the millions of claims that go through our complex health care system each day represents an intolerable and unnecessary disruption,” says AMA President Robert M. Wah in a statement. “Robust contingency plans must be ready on day one of the ICD-10 switchover to save precious health care dollars and reduce unnecessary administrative tasks that take valuable time and resources away from patient care.”