ICD-10: Then & Now - Arkansas HFMA. … · 2014 Efforts Congressional Action –March 31 2014...

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Proprietary and Confidential

Tami Harlan, JD Deputy Director, Arkansas Medicaid

Cathy Munn, MPH RHIA CPHQ

October 29, 2015

ICD-10: Then & Now

© 2015 Proprietary and Confidential

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● DMS Overview

● ICD-10: Then

� Preparation Efforts

• DMS

• HP

• Business Partners

● ICD-10: Now

� The First 29 Days

� Lessons Learned

� ICD-10 Next Steps

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● Department of Human Services

a) Division of Medical Services

i. 832,500 Medicaid Recipients

ii. 38,000 Medicaid Providers


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● Business Partners

� HP

� AFMC

� Value Options

� Qsource*

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● Preparation Efforts 2011 - 2012

� Cognosante Contract Signed in 2011

a) Impact Assessment

b) Requirements Gathering

� Identification & Translation of ICD-9 Codes

a) Edits & Audits

b) Medical Policy & Reports

c) Pharmacy Edits

� Collaborative effort with all business partners

a) HP

b) AFMC

c) Value Options

d) Qsource



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● Preparation Efforts 2013

� Creation of Risk & Issues Documents

a) Identification of potential risk across the agency

b) Development of risk mitigation plans

� Early Collaborative Efforts

a) AR ICD-10 Website

b) AR ICD-10 Mailbox

c) Communications Workgroup

� Provider Outreach Efforts

a) HP Provider Education Workshops

b) Over 250 Participants

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● 2013 Outreach Efforts

Date Audience Location Number Attending

May/June, 2013 Providers Little Rock 165 Participants

July, 2013 Arkansas Waiver Association Hot Springs 31 Participants

August, 2013

Developmentally Disabled

Provider Association Little Rock 94 Participants

October, 2013 Arkansas HFMA Little Rock 20 Participants

October 2013

Value Options RSPMI

Providers Little Rock

90 Participants via

Webinar

November/December, 2013

HP Annual Provider

Educational Conference

Hope

Little Rock

Jonesboro

Pine Bluff

Total of 254 participants

December 2013

AFMC Annual Medicaid

Educational Conference Little Rock

Approximately 400

Participants



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● 2014 Efforts

● Congressional Action – March 31 2014

� President signed SGR legislation into law on April 1, 2014

a) Legislation included a 1-year delay for ICD-10

� CMS announces proposed date of October 1, 2015 in IPPS

proposed rule released on April 30, 2014

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● 2014 Efforts

● Despite the delay, all ICD-10 initiatives continued:

� Creation of Content Based Testing Tool

� Creation of Transition Plan & Dashboard

� Initiation of Risk & Issues Workgroup Meetings

� Creation of Additional Provider Messaging

a) HP Provider Wire Articles

b) RA & On-Hold Messaging

c) Twitter Messaging

� Collaboration with AMS & AHA



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● Initial Provider Readiness Findings – 2014

� AFMC randomly surveyed 571 practices across the state

a) 134 Responses (23%)

� HP Provider Educational Outreach – Fall 2014

a) 5 locations across the state – urban & rural

b) Over 450 participants

� Apparent lack of preparation & readiness based on survey

findings

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● 2014 Outreach Efforts


April, 2014

Arkansas Therapy

Association Little Rock 32 Participants

April, 2014

Value Options RSPMI

Providers Little Rock 84 Participants via Webinar

May, 2014

Mental Health Clinical

Directors Little Rock 13 Participants

September 2014

Developmentally Disabled

Provider Association Little Rock 66 Participants

October, November &

December, 2014

HP Annual Provider

Educational Conference

Hope

Pine Bluff

Little Rock

Paragould

Springdale

Total of 463 Participants

December 2014

AFMC Annual Medicaid

Educational Conference Little Rock

Approximately 400

Participants

December 2014 Arkansas Medical Society

Practice Managers

Workshop

Little Rock 21 Participants



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● 2015 Efforts

� No Additional Delays Anticipated

� Continuation of Previous Initiatives

� Additional Provider Readiness Survey Conducted

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● Follow-up Provider Readiness Survey Findings – 2015

� 134 Practices randomly surveyed in 2015

a) 66 Responses (49%)

� Expanded questions posed in second survey

a) Dual coding

b) Back-up billing plan

c) Networking with local healthcare providers

� Continued concern regarding the lack of provider preparation



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● 2015 Provider Outreach Efforts


March, 2015

Arkansas Therapy

Association Little Rock 10 Participants

June, 2015

Value Options RSPMI

Providers Little Rock

65 Participants via

Webinar

July, 2015

DDS Children’s Services

Early Intervention Little Rock 11 Participants

July – August, 2015* Town Hall Meetings Multiple Locations 676 Participants

August 11, 2015 DDPA Providers Little Rock 55 Participants

August 12, 2015

UAMS Satellite Hospitals

and Mental Health

Centers

Video broadcast across

the state

~18 UAMS Sites across

the state viewed the

presentation

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● Targeted Provider Education & Town Hall Meetings



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● Targeted Provider Education

Date Location Participants

Week 1Camden, Hope, Jonesboro,

West Memphis, Searcy

214 Participants

Week 2Fayetteville, Ft. Smith, Little Rock 208 Participants

Week 3Warren, Pine Bluff

68 Participants

Week 4Mena, Hot Springs, Bull Shoals,

Mt. View, Russellville, Conway

186 Participants

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● Town Hall Observations

� Specialty Providers were at greatest risk

a) Behavioral Health

b) Day Treatment Centers

c) Developmentally Disabled

� Positive correlation between geographic location & readiness

� Providers just want the code translations!



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● 2015 Efforts

� 90-Day HP ICD-10 Testing Window

a) June 1, 2015 – August 31, 2015

b) Over 75 unique providers tested with HP

c) Issues identified and resolved during testing

� Initiation of Transition Work Plan & Checklist

� Monthly Risk & Issues Workgroup Meetings

a) All risks were reviewed & updated monthly

b) Meeting were held with those unable to attend

c) Remediation Plans were developed

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● 2015 Efforts…..the Last 60 Days

� Development of ICD-10 Resource Collateral

a) ICD-10 Talking Points

b) Provider Call Log

c) ICD-10 Handy Resource Guide

� Extensive Training – Internal Staff & Business Partners

� Developed Daily Dashboard of Critical Metrics

� Initiation of Internal Command Center

� Daily Stand-up Calls Initiated October 5, 2015


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● October 1, 2015….

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● Week 1



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● Additional Metrics - Week 1

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● Additional Metrics

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● Additional Metrics



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● Ongoing Efforts

� Daily Calls with CMS

� Daily Stand-up Calls Continue

� Trending of Operational Metrics Continues

� Submission of Operational Metrics to CMS

� Increased collaboration with all business partners has

contributed to a successful transition

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● Types of Calls Received Included:

� When do we start using ICD-10 codes?

� I need the ICD-10 code translations

� How do I update PES so I can submit claims?

� Where can I find the ICD-10 translations?

� Why can’t you give me the translations?

� I didn’t know anything about ICD-10



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● Command Center Calls Provided Humor….

� Caller wanted to talk to the Security Officer

� Caller wanted to sell an extended warranty for a car

� Caller wanted to report a store selling “Camel Golds”

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● Resolved Issues Include:

� Submission of vision codes

� Submission of codes containing decimal point



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● Lessons Learned

� Critical Things to Remember

a) Thorough Preparation

b) Document EVERYTHING

c) Communication Among ALL Stakeholders

� Maintain a Sense of Humor

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● Continue targeted ICD-10 initiatives through the end of 2015

● Utilize data to continue payment initiatives & other areas of

focus in 2016 and beyond…



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● Questions….

ICD-10: Then & Now - Arkansas HFMA. … · 2014 Efforts Congressional Action –March 31 2014...

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Transcript of ICD-10: Then & Now - Arkansas HFMA. … · 2014 Efforts Congressional Action –March 31 2014...