COVID-19 Update: Read our messages to employees and clients

COVID-19 UPDATE
April 22, 2014
ScribeAmerica continues ICD-10 preparation

The anticipated change to International Classification of Disease (ICD-10) reimbursement codes has loomed over the healthcare industry for quite some time, and the legislation recently signed on Tuesday April 8th  further delays the actual date of switch from the currently-used ICD-9 to the new coding system until October, 2015. However, Section 212 of the Protecting Access to Medicare Act of 2014 (H.R. 4302) reads as follows: “the Department of Health and Human Services (HHS) may not, prior to Oct. 1, 2015, adopt ICD-10 code sets,” indicating that the change could be much later, with an actual date still dependent upon the federal legislative process.

Having no date for ICD-10, leaves many physician groups, healthcare organizations and hospitals who have been preparing to change to billing using ICD-10 codes later this year in limbo.

One healthcare service provider, Scribe America, detailed their ICD-10 planning. As a company that offers medical scribe services, including clinical documentation and coding to healthcare practitioners, this business has a finger on the pulse of what the US Healthcare profession is doing to implement this change.

“Starting one year ago we created our ICD-10 training material for our scribes that includes an introductory video that explains what ICD-10 is and teaches them about the implementation of ICD-10 versus ICD-9, which is what we are working under now. The video imparts an understanding of the changes; the scribes will be tested on their knowledge of ICD-10 and they will have to pass this test to be considered competent to continue working for us,” said Jackie McDonald, Executive Vice President of Operations at Scribe America, who is overseeing the implementation of ICD-10 in her company.

Ms. McDonald continued to outline the training program: “We then created training videos for each of our 21 medical specialties, ophthalmology, radiology, pediatrics, et cetera. After our scribes pass the test on the introductory information, they will be required, to take the training video for whichever specialty they are working in and to pass that exam as well.”

The specialty videos focus on the most common clinical diagnoses, or clinical conditions. Each clinical condition is broken down to the exact clinical components that need to be documented to ensure that the documentation is ICD-10 compliant.

An example could be given for the emergency departments, since they are the majority of Scribe America’s clients. A common clinical condition in the emergency room is abdominal pain, which has three clinical concepts that must be documented by ICD-10 standards: the type of pain, the findings, and the location. There are several different clinical concepts that must be documented for each hundreds of clinical conditions.

The Centers for Medicare and Medicaid Services estimate the previous delay of the ICD-10 switch to 2014 has cost between $1.1 billion and $1.6 billion, and further estimate that delaying the switch another year will cost at least that amount and probably more since most organizations are further along in their preparations for the ICD-10 transition. In cases where training has already taken place, many healthcare professionals will simply forget what they have learned over the one year’s delay in implementation.

However, the effect of the delay on Scribe America has been to postpone scribe training to minimize the impact of the delay on costs and the need for re-training. According to Ms. McDonald, “The implementation date had been set for October 1, 2014 so we developed training to be rolled out during this summer and to train our scribes during June, July and August so that each one of our current scribes would be compliant by September and then the training would be made available to our new hires”.

Ms McDonald continued, “As of April 1, we’ve had to adjust our training schedule; we are training only on an as needed basis. We have had three emergency rooms that have implemented ICD-10 documentation procedures prior to the actual date that it can be used. Our entire set 45 project leaders will be trained in ICD-10 and then they will offer training to any of our clients who wants to go live before next year. I believe many more will want to move forward with training, “she said. “ We have stopped training scribes until the date for implementation is set, except on an as needed basis based on which of our clients want to move forward, so we will just pick up next year with the overall training of our scribes.”

Ms. McDonald believes many of the clients are probably underprepared; “I don’t think the extra year delay will push the client – those not prepared this year won’t be prepared next year,” she said.

She is concerned that the clients will be underprepared and, since the medical scribes can only write down what the doctors tell them to write, measures are needed to counteract this. Currently, scribes are being trained to do what ScribeAmerica has coined ‘TASC’. “Scribes will prompt the provider by asking for Timely and Appropriate Scribe Clarification. Using the emergency room example, if the location of abdominal pain is missing from the report, our scribes will prompt the provider in order to remind them that the location of the pain is still needed. We have created cheat sheets with all the emergency room clinical conditions and the clinical documentation so the scribes will be able prompt the providers to create compliant documentation.”

Asked about the overall impact of ICD-10 on this business, she commented, “We have seen a tremendous jump in interest from individual practitioners in the past few months, we are expanding greatly in the outpatient setting, where there here has been an increase in need from single providers to ensure their documentation is compliant and won’t result in penalties.”

Care Navigators
As healthcare business models evolve, so should care teams.

Patients who are paired with Care Navigators report feeling less anxiety, and an increased ability to self-manage their conditions between visits. And providers report increased job satisfaction from improved efficiency, and knowing their patients have access to care teams, and strategic support.

LEARN MORE AT CARETHROUGH.COM
Chronic Care Management
With an increased aging population managing two or more chronic illnesses, extending your care teams’ ability to communicate with patients is critical. We take a strategic approach to helping patients chart a path towards their health goals, while self-managing their chronic conditions between clinical visits.

LEARN MORE AT CARETHROUGH.COM
Artificial Intelligence
Our advanced AI solutions tackle complex documentation challenges to reduce the administrative burden preventing doctors from delivering precision care. We'll guide you through the best practices for incorporating AI into your workflow. Gain visibility into your data with enhanced analytics driven by AI and CTAs.

LEARN MORE AT SOUNDLINES.COM
Nurse Care Team Assistants
Adding a qualified Nurse CTA to the care team increases quality of work-life and reduces stress on nurses. The nursing profession is also experiencing an alarming shortage due to increased clerical burdens and burnout.

LEARN MORE AT CARETHROUGH.COM
Revenue Cycle Management
Transition Revenue Cycle Management into the modern age with a suite of software tools that will transform your billing and coding processes. Transact at lightning speed, with increased transparency and decreased siloes. The QueueLogix software application seamlessly integrates with existing EMRs to ensure the clinical activities and back-office operations are well aligned, monitored and successful.

LEARN MORE AT QUEUELOGIX.COM
Referral Management
Referrals scheduled by navigators in the clinical setting builds long term, patient care integrity across the care continuum. With the authority, along with the provider to search for specialists in network, navigators assess their schedules, and ensure appointment compliance.

LEARN MORE AT QUEUELOGIX.COM
Scribe Services
There’s a reason why we’re the nation’s most frequently used scribe company: we offer professionally trained in-person and virtual medical scribes to meet the specific needs of our clients. We offer a variety of scribe programs, as well as technology and personnel solutions that address revenue cycle management, the transition to value-based care, and more through our HealthChannels family of companies.

LEARN MORE AT SCRIBEAMERICA.COM