Medicare Compliance & Reimbursement
Relay Health Sees Just 1.6 Percent of ICD-10 Claims Denied
While health care providers continue to report positive results with ICD-10 claim submissions, the proof is in the results from claims processors, which appear to echo the successful sentiments.
This week, revenue cycle management solution provider Relay Health Financial shared its denial rate data for claims that were processed between the ICD-10 implementation date of Oct. 1, 2015 and Feb. 15, and the outcomes were quite impressive. Out of over 262 million claims representing more than $810 billion in reimbursement, only 1.6 percent were denied — a shockingly low number by any measure.
“The good news is that we’re not seeing a marked increase in claim denial rates, and there is heightened interest in denial management and prevention,” said Relay Health’s Marcy Tatsch in a Feb. 29 statement. “The bad news is that as many as one in five claims is still denied or delayed–which can mean a dip of as much as three percent in a hospital or health system’s revenue stream.”
The next day, CMS announced the launch of its “Next Steps Toolkit” so providers can track their ICD-10 progress and address opportunities for improvement. The agency offers checklists and actionable steps to ensure that practices are fully embracing ICD-10 and choosing the correct codes every time.
Resource: For more from CMS on its Toolkit, visit www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10NextStepsToolkit20160226.pdf.
Medicare Compliance & Reimbursement
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