HealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
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View All ProductsThe leadership development program from HealthStream helps mold your high-potential healthcare employees into proven leaders.
View All ProductsFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
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View All ProductsTeach your healthcare staff about the revenue cycle and claim management through targeted training and video tools from HealthStream.
View All ProductsIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsNurture the skills of your nurses and medical staff to help mold them into effective leaders with development training from HealthStream.
View All ProductsMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
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View All ProductsAutomated, web-based provider credentialing and enrollment software for growing medical groups.
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View All ProductsFinally, a comprehensive resource to support collecting, storing, and sharing credentialing data with ease.
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View All ProductsMitigate risk and elevate your quality of care. Improving both clinical and business outcomes starts with a smarter, more integrated approach to regulatory training, continuing education and quality management.
Learn MoreThis blog post excerpts an article in the Q4 2015 issue of PX Adviser, our quarterly magazine designed to bring you thought leadership and best practices for improving the patient experience.
With the ICD-10 deadline just behind us, it is clear that ongoing competency maintenance and remediation will be key factors in optimizing the revenue cycle long term. We asked ICD-10 content expert Tom Ormondroyd, Vice President and General Manager, Precyse Learning Solutions, to share some words of wisdom on a successful transition. Starting with organization-wide buy-in, Ormondroyd outlines ways to ensure the best outcomes and avoid some of the worst consequences.
HealthStream: Now that healthcare organizations have made it over the initial ICD-10 hurdle, what is next? Is a maintenance of competence approach needed?
Ormondroyd: ICD-10 is not a quick sprint, but an ongoing journey until ICD-11. For this reason, we need to master our performance in ICD-10 to ensure appropriate payments, optimize documentation, and decrease compliance risk. Maintenance education and remediation are important for all employees engaged in the revenue cycle. Medical coders, for example, must sharpen their foundational skills not only in ICD-10, but also for CPT and other coding rules and systems. They must improve confidence in newer concepts such as ICD-10-PCS and hone their clinical acumen due to the specificity of the new codes. For physicians, improving documentation requires ongoing initiatives to ensure optimal documentation across the entire patient encounter. Case Managers and other care coordinators need to keep abreast of new issues and regulations impacted or related to ICD-10. If so, who needs this type of training? Anyone that was trained in ICD-10 initially needs to be part of this maintenance initiative. Yes, coders, billers, physicians, clinical documentation improvement specialists, case managers and others are most critical, but anyone who documents or supports the documentation of the medical record or interacts with an ICD-10 code should be part of this initiative.
HealthStream: Besides ICD-10, what other coding issues should healthcare organizations be concerned about?
Ormondroyd: Organizations have been so focused on ICD-10 that they have taken their eye off the ball on other coding issues that continue to wreak havoc in our industry. CPT still causes many challenges—not just for coders—but for many healthcare professionals. CPT is used far more often by non-coding individuals who have not been trained on its use, which is dangerous. But, systems like CPT and HCPCs continue into the world of ICD-10 and will draw added scrutiny as more specific ICD-10 codes will be required to show the medical necessity of the procedures, tests, and materials we use. We also need to be very aware of the many updates and changes that are made annually. CPT went through significant updates this past year, so we expect a very large update to ICD-10 once the code freeze is lifted. Also, there are others areas like modifiers, Evaluation and Management (E/M) levels/ codes, and code edits that are causing confusion and challenges. All of these areas are ones we should focus on. Lots of money is being left on the table for the tremendous patient care and services we provide, due to lack of understanding and training.
HealthStream: What suggestions do you have for healthcare organizations that are experiencing negative financial consequences due to the transition to ICD-10? What are the best steps they can take to improve their revenue cycle management?
Ormondroyd: You need to get to the bottom of why negative consequences are occurring, and you have to do it right away. There are many reasons why ICD-10 could cause a negative impact, but none are because of the system itself. Remember, ICD-10 provides far more choices to show the severity of our patients’ illnesses, so we cannot blame the system. In this way, there are several places they could look for deficiency, but three of the most likely offenders are the codes they select, the documentation they document, or the delays in their revenue cycle. If coding is inaccurate, incomplete, or not appropriate, then it is highly likely that the organization is leaving money on the table or increasing the likelihood of denials. To resolve this, have an external coding audit completed to see where your biggest issues reside or if certain coders need additional training. Use coding assessments to look directly at areas where the coders are struggling and attack those with education. If documentation is the challenge, then do the same thing—perform audits of your documentation to see if certain diagnoses or certain physicians are posing the problem or if the issue is widespread. If the problem is a delay in the revenue cycle, they need to check with the HIM leadership and find out whether the delay is due to decreased coding speed or if they are being held up due to lack of query responses or something else. Delays in the revenue cycle can cause significant cash impacts as more and more money is not billed, and of course, not paid.
HealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsThe leadership development program from HealthStream helps mold your high-potential healthcare employees into proven leaders.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
View All ProductsLearn about what HealthStream's healthcare policy management software and how it can help aid your organization efforts.
View All ProductsHealthStream's education helps address diversity, equity, and inclusion within your organization, as well as promoting health equity in the communities you serve.
View All ProductsHealthStream offers professional training and education on how to best optimize your reimbursement process within your healthcare organization.
View All ReimbursementTeach your healthcare staff about the revenue cycle and claim management through targeted training and video tools from HealthStream.
View All ProductsLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ResuscitationIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsNurture the skills of your nurses and medical staff to help mold them into effective leaders with development training from HealthStream.
View All ProductsExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
View All ProductsLearn more about HealthStream's provider credentialing, privileging, & enrollment solutions for healthcare organizations.
View All CredentialingExperience standardized and centralized healthcare provider credentialing, privileging, and enrollment that is smarter and faster than ever before.
View All ProductsAutomated, web-based provider credentialing and enrollment software for growing medical groups.
View All ProductsNCQA-certified CVO verification services for initial and re-credentialing files in an overflow or full-service capacity for healthcare organizations.
View All ProductsSearch, review, and add providers into the Epic provider master file with our Epic app integration, Provider Validate.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All SchedulingHealthcare scheduling software designed to optimize staffing requirements & elevate patient care
View All ProductsPrecisely align staffing and needed resources to enable efficient patient flow and high-quality, cost-effective patient care.
View All ProductsHealthStream’s free nurse schedule app, NurseGrid™, is built to help you care for your staff and engage with their specific needs.
View All Products