Is your practice ready to get serious about wellness? If so, re-read the post linked above, poll staff about which health and fitness goals they’re most interested in, determine a start date for your program, and then make it stick throughout 2012 by following these guidelines.

Encourage office-wide participation. Hopefully, not everyone in your office needs to lose weight, stop smoking, and reduce their cholesterol numbers, but it’s likely that everyone in your office could benefit from improving their health and fitness in at least one area. Your wellness program will be more sustainable over time if the majority of your staff participates. It is especially helpful for practice administrators, department managers, and, yes–even doctors–to take the lead and set a good example by choosing at least one aspect of the wellness program to engage in.

Set up incentive programs that include both short-term and long-term rewards. If six of your employees declare weight loss as their goal, arrange for rewards to be given throughout the year. You might offer cash bonuses (e.g., $5-10 per pound lost) divided equally among the six employees based on their collective weight loss each month, paid hours off calculated at the end of each quarter for each individual’s weight loss, and one big celebration or group outing at the end of the year if weight loss goals are achieved.

Hire a professional. Visit the International Coach Federation’s Web site to find an experienced wellness coach in your area who can work with your staff as a whole, in small groups, or even one-on-one. Having an objective professional on your wellness program team will increase accountability and the odds that employees will be successful in achieving their goals.

Go public. If employees agree–and only if they all agree–consider going public with your program as a way to draw attention to the fact that your practice is serious about health and wellness. Doing so sets a good example for patients and builds in accountability for staff. The way you go about making it known to those outside your immediate circle will depend on how open everyone is willing to be about their goals and progress. You might put up a small poster in the office with photos of staff along with quotes by each of them about why they’re serious about health and fitness or what they hope to achieve. You could post updates on your practice Web site or in your patient newsletter. If you really want to tell the world what you’re up to, notify the local media about doing a story on your wellness program.

Good luck making 2012 the year that you and your staff achieve your most important health and fitness goals.

Breast cancer is the second leading cause of death in women (lung cancer is first). Every year, almost 40,000 women die from the disease. National Breast Cancer Awareness Month is celebrating 25 years of bringing attention to this all-too-common illness, and throughout the month of October you can expect to see lots of pink ribbons (and even pink-streaked hair!) everywhere you go.

If you’re so inclined, you can raise money to fight breast cancer using your feet by signing up for the Avon Walk for Breast Cancer (www.avonwalk.org) or the Susan G. Komen 3-day for the Cure® (www.the3day.org). Both events involve walking fairly long distances (39 and 60 miles respectively) over two or three days and getting pledges for your effort from family and friends. Participants can trek as individuals or form teams to increase motivation and add to the fun factor. If you can’t walk yourself, ask around and you’ll likely find someone you can sponsor who is participating in one of these national walks (they’re both held in multiple locations around the country). Many communities also host shorter, local fundraising walks to raise money for breast cancer. Check your local paper to see what might be happening in your area.

Depending on your specialty (or perhaps if you have a staff member who has experienced breast cancer) you might enjoy investing in some special promotional items this year. Medical Arts Press® has many pink-ribbon logo office supply items from which to choose.

For both staff and patients, check out www.nbcamproducts.com to find pink ribbon logo tee-shirts, tote bags, water bottles and much more. A portion of each sale goes toward breast cancer education. Another site with an abundance of pink is www.shopkomen.com, where you can find educational materials in addition to unique wearable and gift items (they even have something for your dog).

If you’d like to inspire your staff to do something this October to help raise awareness about or money for breast cancer, take a quick break and gather everyone around the computer screen. Click on www.pinkglovedance.com. Scroll down and watch one of the Pink Glove Dance videos that have become a national sensation. Be sure to have the tissue box handy – you’ll need it.

To order Florida prescription blanks click here.

On December 8, 2010 Congress passed legislation that exempts physicians from the FTC’s Red Flag Rules. For more information on you can visit the Physicians Practice blog at: http://www.physicianspractice.com/blog/content/article/1462168/1752034

Copyright© 2010 by UBM Medica. www.PhysiciansPractice.com All rights reserved.

By Deborah Grider

It is now only 37 months before ICD-10-CM becomes a reality. There’s much to do before October 1, 2013, but implementation can be a smooth transition if you take a systematic approach. There are many elements that need to be addressed, but preparing your practice in a step-by-step fashion can keep the transition from becoming overwhelming.

Planning and implementing ICD-10-CM must include communication and significant collaboration on information technology, finance, education, and problem solving. The work necessary to implement ICD-10-CM and the resources required will depend on the size of the practice. A large practice may need to recruit key people from many different departments and areas of the practice to assist with the transition; a small practice might enlist only one or two staff members to assist in the transition.

Version 5010
The transition to Version 5010 of the Electronic Data Transactions (EDI) must be made no later than January 1, 2012 — prior to ICD-10-CM implementation. Version 5010 must be implemented because Version 4010A cannot accommodate the expansion of the code sets that include ICD-10-CM and ICD-10-PCS. You will not be able to send claims or receive reimbursement without the 5010 conversion.

You’ll need the help of your software vendors to make this transition. My advice is to contact them now because level I testing (the vendor’s internal testing) also should be happening now. Make sure the software conversion occurs prior to January 1, 2012, in case there are problems with the conversion that must be fixed prior to the “drop dead” date.

Organize implementation
Every practice needs to assign a project team or key person to organize and manage the implementation effort. If you have several people in your practice involved in the ICD-10 transition, form a team and assign projects with completion dates during each step of the process. The transition team or key person is responsible for the initial planning process.

Include at least one physician in the implementation process, as well as your management and coding staff. It’s important to have the physicians involved so they understand the importance of preparation as the transition occurs. Ask the project team to provide periodic progress reports so everyone is aware of the progress, problems, and barriers to implementation in your practice.

After leadership roles have been identified, it’s time to get to work. The first step is preparing a project summary, including an overview description of the regulation, changes to the code set, the anticipated scope of work that needs to be accomplished, and anticipated internal and external work processes. For larger practices this could mean reading the ICD-10 final rule; for smaller practices this could mean reading materials prepared by a professional society. The project summary, along with an outline of project steps, will serve as the roadmap for completing the implementation. This summary should be shared with the physicians in your practice.

Impact analysis
A preliminary impact analysis is a good tool for assessing which areas of your practice may be affected most in the early stages of ICD-10-CM implementation. After the analysis is complete, the project team can develop a budget for ICD-10-CM implementation. Vulnerable areas may include:

• Information systems

• Documentation

• Staff education needs

• Clinical and administrative areas

This information must be shared with the providers so they understand the depth of the changes. It is important in this planning stage to identify who in the medical practice or organization has decision making authority.

Information systems
Conducting a system audit for ICD-10-CM compatibility is part of the impact assessment. Start by performing a comprehensive audit of all data systems currently using ICD-9-CM, and then analyze the systems that will use ICD-10-CM. Your analysis should answer the following questions:

• How are ICD-9-CM codes currently used in information systems?

• Which vendor software applications are being used?

• How are codes entered? Are they manually entered or imported from another system or software?

• Can the system handle alphanumeric structure? It must be able to.

• Can the codes, code descriptions, and supported documentation be obtained in a machine-readable format?

• Does the code format include a decimal?

• Can the current system house both ICD-9-CM and ICD-10-CM codes simultaneously?

• How is the quality of data checked?

• How do the systems interface?

After you perform a comprehensive audit of the IT systems, perform an analysis of necessary changes to be implemented for the transition to ICD-10-CM. Identify which forms and reports will need to be reformatted or revised. Evaluate whether each system’s storage capacity is sufficient to support both ICD-9-CM and ICD-10-CM during the transition, or if the capacity will need to be increased. Also consider how long ICD-9-CM will be accessible, which staff will need to access ICD-9-CM, and how long the legacy data will need to be available.

System vendors
Contact system vendors during this phase to determine whether they can support legacy and new coding systems, and for how long. This is an ideal time to identify costs for upgrading software and storage capacity, as well as contract issues with the vendor. Other potential vendor costs may include hardware upgrades, customization, staffing, and overtime.

Determine if upgrades are included in the current contract or if there will be additional costs to upgrade. Coordinate with the vendor to create the timeline for testing and installation of the new or upgraded software or system. Other IT system considerations might include a conversion to an EHR during this transition, if the organization hasn’t previously converted.

Documentation
Because ICD-10-CM is more robust (with up to seven digits of specificity), assess whether documentation currently in your medical records will support the level of specificity necessary for ICD-10-CM.

The organization should have an experienced auditor conduct audits either internally or externally. Random samples should be evaluated and various types of medical records should be reviewed. A clinical documentation assessment tool should be used to conduct this audit to be sure current documentation adequately supports ICD-10.

When an audit has been conducted and analyzed, the practice will have a good assessment of any deficiencies, and can develop a priority list of diagnoses requiring more detail. The audit also helps identify providers who will benefit from focused training using ICD-10-CM.

Coding and billing education
Everyone in the medical practice will need some form of training. Physicians, nonphysician providers (NPPs), coders, and billing staff will need more extensive training than ancillary staff (nurses, MAs, managers, etc.).

Questions to ask:

• How much training on ICD-10-CM will be necessary?

• How many training days will be required?

• Will there be lost revenue if the practitioners need to be out of the office for training?

• How will productivity be affected?

• How much training does each staff person need?

Some studies indicate that less than 16 hours of training is necessary on ICD-10-CM. The reality is that physicians will need approximately 16 to 20 hours of training, coders will need 40 to 60 hours of training, and other staff might need approximately six to 10 hours of training.

Finances
Because reimbursement is tied to procedural and diagnosis coding, your practice’s finances will be affected greatly by the transition. For example, after the implementation date, if an insurance carrier cannot accept ICD-10-CM codes, your practice probably will not be paid by that insurer. Make sure you know which of your payers have fully transitioned to ICD-10-CM and which have not, so you can do your billing accordingly to ensure you get paid.

Review the current reporting for procedures and services using ICD-9-CM and compare them to ICD-10-CM codes. Professional services are paid based on the procedure code, but the diagnosis code supports medical necessity — the driving factor in payment for all medical procedures and services.

Reports tied to diagnosis codes, such as the accounts receivable analysis, pending claims reports, analysis by provider type, and collection reports also will be affected. Assess which reports will be affected by the ICD-10-CM transition and what changes will need to be made.

Post implementation
The impact of the ICD-10-CM transition on your practice will not end on the October 1, 2013. Pended or denied claims are expensive, and generally are dealt with through a manual process. Any increase in the number of claims not processed or paid will first decrease provider cash flow, then increase both provider workload and plan workload to process the denials. To reduce the risk of reduced cash flow, providers and staff need to know and understand the changes in documentation and coverage requirements well ahead of time to adapt in time for implementation.

It is a fact that people’s productivity decreases short term when they are in training or learning a new skill. These slowdowns result in loss of productivity, including charge capture and reimbursement, and can affect the financial health of a practice. Anticipate a decrease in productivity by measuring and analyzing the impact of the transition prior to beginning the training process. Planning ahead also allows you to try a staggered training approach, where one group of providers and staff is trained at a time, helping to limit the impact on productivity.

Analyzing all areas affected by ICD-10-CM and making operational changes within your practice to accommodate the new code set will ensure a smoother transition to ICD-10-CM. Thirty-seven months may seem like a long time away, but successful implementation depends on planning ahead and allowing time for resolving issues with vendors, equipment, documentation, and training. Getting started now means less stress later in the process.

Copyright© 2010 by UBM Medica. www.PhysiciansPractice.com All rights reserved.

Starting October 1, 2010, all practitioners will be required to use prescription pads which comply with guidelines by the Centers for Medicare & Medicaid Services (CMS). This deadline is approaching rapidly and prescribers need to stock up on the new tamper-resistant prescription pads. This law will not affect practitioners who are enrolled in the Medicaid program since they are already subject to these requirements. For more information on the new requirement you can visit the State of Delaware Web site at http://www.dpr.delaware.gov/

Medial Arts Press can provide you with these tamper-resistant prescription pads. Please visit our Web site at: http://www.medicalartspress.com/alter-proof-rx-blanks-rx-blanks/cbl/7560.html