New online tool calculates ICD-10 financial risk exposure


Physician practices looking to assess their exposure to financial risk in relation to ICD-10 compliance have a new online tool at their disposal. The HIMSS ICD-10 Task Force and Jvion, a healthcare compliance technology and services organization, announced on June 27 the release of their collaboratively developed ICD-10 Financial Risk Calculator Self Assessment.

The new interactive resource, available here, prompts a practice to answer a short survey. For example, after identifying organization type as a physician practice in an ambulatory setting with between 1 and 25 practicing providers, the survey asks questions such as:

  • In what general range were your 2011 revenues?
  • What is your average denial rate
  • What percentage of your revenue comes from Medicare?
  • What is your largest specialty by revenue?
  • What is your revenue cycle?
  • What is your current daily average claim acceptance rate into your clearinghouse?
  • What percentage of your current credit line(s) are you using to fund operations?
  • Do you have an EMR upgrade of other major system upgrade that is currently underway or planned within the next year?
  • Do you have a process in place to measure reimbursements against contract-negotiated amounts?
  • Who will be assigning diagnosis codes when ICD-10-CM is implemented?

In total, the practice supplies multiple-choice answers to 25 questions. All information input into the calculator remains anonymous. You may preview the survey prior to completing it.

At the end of the survey, the practice receives individual financial risk ratings across revenue, operational cost and cash flow categories. The practice also receives relative risk ratings, which enable comparison of your risk ratings to other practices in your peer group.

In addition, the calculator generates specific mitigating steps that your practice can take to address your financial risk exposure and optimize reimbursements.

You may e-mail a copy of the report to yourself or another recipient. It takes two to three days to receive a copy of your report.

"By simply answering a short survey, providers receive unique insight into the powerful impacts of ICD-10, steps they can take to address those impacts, and ways to augment their accounts receivable even before they complete their conversion to ICD-10," said Juliet Santos, HIMSS senior director of business-centered systems.

"This tool will help providers set priorities for their ICD-10 planning and conversion efforts to improve their reimbursements," added Dwan Thomas Flowers, co-chair of the HIMSS ICD-10 Task Force.

For additional information on ICD-10 compliance, visit HIMSS' ICD-10 Playbook.