Jvion Releases HIMSS ICD-10 Financial Risk Calculator Findings

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As the lead for the HIMSS ICD-10 Financial Risk Calculator, Jvion spearheaded a report on initial findings and trends captured through the tool. The information analyzed supports industry concerns over ICD-10 revenue cycle impacts, ICD-10 reimbursement shifts, coder productivity, and physician education.

ICD-10 Financial Risk, ICD-10 Codes Conversion, ICD-10 Revenue Cycle, ICD-10 Reimbursement
What we found through these self reports really underscores how important it is that providers understand their reimbursement risks as they start their ICD-10 preparations.

Jvion has been at the center of the HIMSS ICD-10 Financial Risk Calculator from inception. In fact, it was the firm’s idea to approach the ICD-10 PlayBook with the concept. “Back in early 2012, we reached out to the PlayBook with the thought of creating a self assessment tool that would help providers understand their financial exposure to ICD-10 revenue cycle and reimbursement impacts,” explained Surya Vadlamani, Jvion CIO and architect for the calculator. “We wanted to provide it as a free service to the community to help providers identify the areas most exposed to ICD-10 revenue risk and the steps they can take to avoid potential reimbursement losses.”

Now that more than 200 providers have leveraged the HIMSS ICD-10 Financial Risk Calculator, the tool is delivering insights into industry preparedness and particular challenges faced by certain provider segments.

Report Highlights:

  •     ICD-10 will continue to stretch already overtaxed resources, specifically within IT and coding departments
  •     There is a general lack of visibility into potential risk areas including coder productivity and third-party vendor readiness to accommodate ICD-10
  •     Low adherence to documentation standards by physicians will continue unless providers engage in the appropriate level of change management and education; without these actions, poor documentation will contribute to increased denials and lower reimbursement rates
  •     While current revenue cycle processes are effective, providers need to revisit them to ensure that they account for ICD-10 related changes and challenges
  •     Many providers plan to monitor reimbursements post October 2014; however, most will do so manually, which leaves open the opportunity for mistakes and backlog
  •     Current denial rates may increase as the industry works to accommodate the new code set; providers need to prepare for this shift and the potential 4-6% drop in revenues*

Allison Alavi, Director at Jvion and Co-lead for the calculator reflected on the study: “What we found through these self reports really underscores how imperative it is that providers understand their reimbursement risks as they start their ICD-10 preparations. And for those who have initiated conversion activities, it is important that they revisit their plans to ensure that they are addressing potential ICD-10 revenue cycle impacts. We are thrilled that the community is using the ICD-10 Financial Risk Calculator self assessment tool as a first step in understanding the code set’s financial risks. The next challenge providers face is identifying the exact codes that threaten reimbursements and then applying that information to develop effective actions that mitigate potential losses.”

To access the full HIMSS ICD-10 Financial Risk Calculator report, click here. And for more information about Jvion and the RevCore ICD-10 Financial Risk solution, please visit jvion.com.

*This estimate is dependent upon an organization’s case mix

About Jvion
Jvion is a healthcare technology company addressing the financial and operational impacts resulting from mandated reforms and compliance activities. We offer a suite of Big Data-enabled software solutions to reduce the financial impact and burden of the ICD-10 conversion, and help providers protect their revenues from increased financial waste associated with mandated changes and increased payor scrutiny. Please visit Jvion’s website at jvion.com for more information.


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Allison Alavi
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