Relative calm also defined the atmosphere among several
insurers. “All is going well,” said Debra Cotter, the ICD-10 project director at Highmark in Pittsburgh. The Blue Cross and Blue Shield plan, which has 5.3 million members and processed 114 million claims last year, has been preparing for the switch to ICD-10 since 2010. It has tested systems with providers over the past year, and then performed quality checks at midnight on ICD-10 day.
“We’re excited to see the years and years and years of work actually in practice,” Cotter said. “We have seen our first claims submitted in ICD-10, and we have finalized a couple claims already.”
But the new code set does not mean ICD-9 will be immediately buried in its grave. For patients who saw their doctor or were admitted to a hospital before Oct. 1, those claims will still have to be submitted in old code. Cotter said Highmark will be ready to juggle both code sets at the same time.
Dr. J. Mario Molina, president and CEO of Medicaid insurer Molina Healthcare in Long Beach, Calif., compared the ICD-10 launch to Y2K, when Americans braced themselves for a technological meltdown.
“We thought the world was going to end, but everything went pretty smoothly,” Molina said. Molina’s business processes have been ready for ICD-10 for more than a year, and claims operations at Molina have been status quo so far, he added.
At Security Health Plan, a smaller, 230,000-member payer owned by the Marshfield (Wis.) Clinic, the impact of ICD-10 won’t be felt immediately. Security received its first claims files the evening of Oct. 1 for services provided earlier that day, said Sara Foemmel, the plan’s claims operations director.
Few hiccups are expected. “We’ve tested a tremendous amount with all of the providers,” Foemmel said.
But insurers can’t rule out potential delays in payment if codes aren’t submitted properly.
“The delay would have to do with the provider recoding the claim and resending it to us,” said Robin Mayhall, a spokeswoman for Blue Cross and Blue Shield of Louisiana. “I don’t think it would be anything too extensive.”