Not only is it important that physicians and coders are well versed on ICD-10, it is also important that the front line staff is trained enough to address the queries of patients. The following are some tips on how to go about it:
Taking in-depth medical history – Healthcare delivery process starts from the front desk employees. Post ICD-10, given its extreme specificity, the responsibility of front desk employees will increase by a huge amount. It will become highly important for them to improve their intake process.
The medical office can avoid potential problems by training their staff to gather the right information from each patient during the intake process. For example, recording well-defined signs and symptoms and finding out exactly when and how a patient’s injury was caused, whether or not there is a liable third party involved, and any past medical issues related to the injury are critical pieces of information that may determine whether the insurance company will pay for the service. By not asking the right questions—and not documenting the answers correctly—the front office threatens a practice’s ability to code that encounter correctly.
Keep calm and handle complaints – It’s no news that in the initial months of implementation, the percentage of claim denials due to errors in coding will increase. This can result in huge losses for practices that aren’t fully prepared. Here again the patients will require an explanation to why it has happened.
Proper training in communication skills and ICD-10 awareness will ensure a seamless transition for your entire practice. The front line staff should communicate the required information to the patients in a welcoming manner. They need to be trained to remain calm and deal the complaints of disgruntled patients. It’s crucial that they come up to their expectations and redress all their billing or insurance related queries in a well-timed manner.
Insurance Knowledge – It is critical for the office staff to have a rudimentary understanding of why a patient’s insurance plan or co-pay may have changed during the Affordable Care Act’s industry upheaval. Other patients may have insurance for the first time and may subsequently have more questions or require greater assistance in understanding their plan and coverage options. In some cases additional information will be required for pre-authorizations in order to meet ICD-10 requirements. Training the front office staff to answer basic questions around insurance changes will ensure a smoother office workflow with fewer interruptions. Some of the changes will be reflected in patient co-pays and the ability to see the practitioners with which they’re familiar. In the first months of ICD-10 implementation, patients may be billed in error to due to unjust claim denials and front office personnel must be able to explain what has happened and why.