Patients Prepare for Inaccurate Bills with New ICD-10 Codes

Bruce Japsen of Forbes reports that healthcare consumers in the U.S. may need a whole lot more patience coping with highly erroneous insurance claims as well as denied health services amidst new ICD-10 codes. Japsen's research points out that at least one analysis said that 1 in 4 of U.S. practices aren’t ready for the ICD-10 transition. Aon Hewitt, a large employee benefits consultancy, says there is the likely possibility that doctors and hospitals will be using outdated codes and bill patients for services that could have been covered.

“The impact of the ICD-10 switchover on the healthcare system will not be fully understood until after claims processing begins on Oct. 1,” said Dr. Steven Stack, the American Medical Association president. However, Medical Group Management Association president and chief executive Dr. Halee Fischer-Wright noted that a recent survey found that, "20% or more of physician practices have not received the billing system updates necessary for ICD-10,” which could significantly disrupt future claims processing. 

New ICD-10 codes have added significant expenses to health insurance companies, impacting even the largest insurers including Anthem, Aetna, Cigna, Humana, and UnitedHealth Group. Despite ongoing efforts to prepare for ICD-10, benefits experts say health plan enrollees could see a delay in authorization for certain tests and procedures if doctors aren’t adequately coding services. Insurance claims could also be denied, but the shift to ICD-10 is a good thing for long-term consideration especially as doctors and hospitals move towards a healthcare system that pays providers based on outcomes and quality.

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