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How ICD-10 Will Change Health Insurance

Guest post by: John Clark

Article Overview: The U.S. HHS, or Department of Health and Human Services, decided in January of 2009 that they would require all health insurance companies and health care providers to work with ICD-10 codes instead of ICD-9 codes as of October 2013.

How ICD-10 Will Change Health Insurance

The U.S. HHS, or Department of Health and Human Services, decided in January of 2009 that they would require all health insurance companies and health care providers to work with ICD-10 codes instead of ICD-9 codes as of October 2013. This pertains to all coding for physician's offices, outpatient settings, and inpatient hospital procedures for coding diagnosis. The reason that the HHS Department is mandating this transition over to ICD-10 is because many members of the health care community agree with them that the presently used code set ICD-9 does not have enough space for new codes and is outdated. They believe that many positive changes will happen with health insurance and the health care industry in general. The data will be greatly improved in the new system. It is believed that this will offer the entire health care system and health insurance companies a significant number and range of benefits. Electronic medical records will be created. On the one hand, the public health oversight will be superior. The data will be better for research and treatments. Payment systems will become faster and more accurate. Abuses and fraud will be discovered more often because the services that are provided by doctors and other health care providers will be more precisely defined. This will lead to lower incidents of fraud that will help to keep health insurance company costs down.

With the expanded set of codes, doctors and physicians will be capable of giving health insurance companies more important clinical information such as body mass index of a person and levels of blood pressure for patients. This will allow for better record keeping of health conditions by health insurance companies for their patients. The hope is that better outcomes for health care will then result.

The upgrades to the new ICD-10 codes are not expected to cost health insurance companies much money per policy holder. For large companies with five million or more members, it is only supposed to run them $11 per member. Medium sized companies with from one million to five million members are anticipated to have $13 per member costs. Smaller companies will naturally have the highest costs per member in making the ICD-10 code changes and upgrades. Those health insurance companies with under a million members are expected to have as high as $38 per member in expenses. The average for all sized health insurance companies only comes in at an average of $12 per insured member in costs.

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Article Tags: department of health and human services, health care providers, health insurance, health insurance companies, icd10 codes, insurance
Referred by: http://www.franchisefix.com/



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