How are providers coping with the delay of the ICD-10 implementation to 2015, when many had established budgets and training for being live 2014? Guests from Prime Health Physicians LLC and Harbor Oaks Eye join our Open Line Friday panel to share their experience. Visit floridablue.com/icd10 for a complete repository of tools and information.

1. 900-3571-0213
Open Line Friday: ICD-10 Edition
A Provider View on ICD-10
and the 2015 Delay
Cesar Ortiz, Prime Health Physicians LLC
Lori Ferguson, Harbor Oaks Eye
May 16, 2014
9:30 a.m. – 10:30 a.m. EST
Dial Toll-Free: (800) 882-3610
Conference Passcode: 6829655#
900-4451-0514

2. Open Line Friday: ICD-10
Panelists
Deborah Stewart, MD
Medical Director
Florida Blue
Gale Scott
EDI Regulatory Compliance
Administrator
Tampa General Hospital
Laurie Darst
Revenue Cycle Regulatory Advisor
Mayo Clinic (MN)
Matthew Ketterman
Director, Business Solutions
Availity®1
Joseph Gonzalez
VP of Business Development
Secure EDI
Lee Ratliff
Clinical Business Technology Consultant
Baptist Health South Florida
Mary Rita Hyland
CPO and VP Regulatory Affairs
The SSI Group, Inc.
Diana Brijbag, CMM, CPC, CCP, CMSCS
Office Manager
The Springs Family Medical Center
George Vancore
Senior Manager, Delivery Systems
Mandates
Florida Blue
1 Availity, L.L.C. is a multi-payer joint venture company. For more information or to register, visit www.availity.com
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3. Open Line Friday: ICD-10
May 16, 2014
Special Guests
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Cesar Ortiz
Chief Executive Officer
Note: Practitioner guests are subject to unforeseen clinical or other emergencies. Should our guest(s) lack availability at the time of our
program, Florida Blue will attempt to reschedule guest(s) for a future session.
Lori Ferguson
Billing Manager
Harbor Oaks Eye
Clearwater

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5. Open Line Friday: ICD-10
ICD-10 Delayed to 2015. Now What?
Agenda
May 16, 2014
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1. Objectives
2. Healthcare Industry Updates
3. Florida Blue Updates
4. A Provider View on ICD-10
and the 2015 Delay
5. Next Steps

6. Open Line Friday Objectives
1. Promote collaboration, communication and coordination between providers, payers
and electronic trading partners.
2. Expand your understanding of the current state of ICD-10, recent regulatory
decisions and industry perspectives.
3. Raise your awareness and understanding of the unique opportunities and challenges
that ICD-10 brings to the entire health care industry including providers, payers and
electronic trading partners.
4. Provide you with tools, techniques, best practices and helpful hints from your peers
that can be used as you continue (or begin) your ICD-10 journey.
**** Please remember that during the call all attendees will be placed on “mute”
except for any guest speakers and all panelists. If you have a question, please
email it to FloridaBlueOpenLineFriday@FloridaBlue.com.
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Open Line Friday: ICD-10

7. Open Line Friday: ICD-10
Health Care Industry & Regulatory Update
On May 1, the Centers for Medicare & Medicaid Services (CMS) announced:
• “On April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was
enacted, which said that the Secretary may not adopt ICD-10 prior to October 1, 2015. Accordingly, the
U.S. Department of Health and Human Services expects to release an interim final rule in the near
future that will include a new compliance date that would require the use of ICD-10 beginning October 1,
2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September
30, 2015.”
• American Health Information Management Association (AHIMA), who launched a heavy lobby effort in
late March to prevent another delay of the new code set, has applauded CMS for deciding to limit the
delay to the one year minimum called for by Congress.
“We know that the industry has already invested considerable time and money in implementation.
We have long advocated for a coding system that offers flexibility and specificity, enables us to
properly assess healthcare services, understand public health needs, and get the best rate of
return from our national investment in EHRs and meaningful use,” said AHIMA officials in a press
release. “All along, AHIMA has urged our members to „stay the course‟ of preparing for
implementation. During the coming year, we recommend that the industry keep its momentum
going, continuing to prepare by strengthening clinical documentation improvement programs,
working with vendors on transition readiness, training coders and other stakeholders, and
proceeding with dual coding.”
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8. Open Line Friday: ICD-10
Health Care Industry & Regulatory Update (continued)
• NUCC recently announced changes to the CMS 1500 professional paper claim form to
accommodate ICD-10 (www.nucc.org); the following is the recommended transition timeline:
• January 6, 2014: Payers begin receiving and processing paper claims submitted on the
revised 1500 Claim Form (version 02/12).
• January 6 through March 31, 2014: Dual use period during which payers continue to
receive and process paper claims submitted on the old 1500 Claim Form (version 08/05).
• April 1, 2014: Payers receive and process paper claims submitted only on the revised 1500
Claim Form (version 02/12).
• CMS previously announced an ICD-9 and ICD-10 code set freeze which has been in
effect since October 1, 2013. Do these code sets require “unfreezing”?
• Several organizations are continuing their ICD-10 testing efforts. Are you planning to?
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9. Florida Blue Update:
• Florida Blue is deploying a full remediation strategy to implement ICD-10.
• Florida Blue‟s ICD-10 initiative is proceeding on plan. We are in the process of
completing our internal Compliance Level 1 testing and are engaged in
Compliance Level 2 testing with providers and external entities.
• Open Line Friday ICD-10 Edition teleconferences will continue every 3rd Friday
of each month. Audio podcast recordings are available through the Podcast link
located at www.floridablue.com/icd-10.
• ICD-10 Testing with Providers: We are continuing to engage providers in Phase I
and Phase II Testing. Phase III is in beta-test mode and will be generally available
in the late May timeframe. Details of our provider testing, including a self-service
option, are available at www.floridablue.com/icd-10.
• Florida Blue‟s ICD-10 Provider Toolkit will be maintained going forward and is
accessible from www.floridablue.com/icd-10.
• Attention Small to Medium sized providers: “Build your action plan and start
your transition to ICD-10 now with the CMS “Road to 10” tool. It‟s simple. Visit the
www.roadto10.org”
Open Line Friday: ICD-10
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10. Cesar Ortiz, MBA, FACMPE , Chief Executive Officer,
PrimeHealth Physicians, LLC, Miami, FL
Lori Ferguson, Billing Manager, Harbor Oaks Eye, Naples, FL
(refer to speakers’ supplemental material*)
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Open Line Friday: ICD-10
A Provider View on ICD-10 and the 2015 Delay
* If applicable, supplemental (guest speaker) program material can be accessed at www.floridablue.com/ICD-10
under Open Line Friday located in right margin.

11. .
Send general ICD-10 questions and comments to
floridablueopenlinefriday@floridablue.com.
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Open Line Friday: ICD-10
A Provider View on ICD-10 and the 2015 Delay

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13. Next Steps
Next Steps and Contact Information
Access our Open Line Friday podcasts at www.floridablue.com/icd-10
ICD-10 Open Line Friday email list: send us your email by contacting us at
floridablueopenlinefriday@floridablue.com
Test ICD-10 with us. Visit www.floridablue.com/icd-10 and select our “Test ICD-10 icon”
for details. Testing questions? Email us at ICD-10Testing@floridablue.com
Access Florida Blue‟s ICD-10 Provider Toolkit and more at www.floridablue.com/ICD-10
Visit the Availity Learning Center (www.availity.com/learningcenter) to access live and webinars
including information about Ready10 - a popular ICD-10 project management tool (see “There’s
Ready and There’s Ready10”).
Add/update your email address so we can keep you informed via email (Bluemail)
Add, update or delete your email and contact information at any time using Availity's secure website. Log
on to Availity at www.availity.com, select Payer Resources, Florida Blue and Update My Email
Information with Florida Blue then follow the prompts.
Open Line Friday: ICD-10
Follow us on Twitter @FLBlue
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14. Addendum
ICD-10 Helpful Resources and Reference Material
• www.cms.gov/ICD10
• www.wedi.org
• www.ama-assn.org
• www.ahima.org/icd10
• www.availity.com
• www.fha.org
• www.hbma.com
• www.mgma.com
• www.floridablue.com/ICD-10
• www.fmaonline.org/HomePage.aspx
• www.cdc.gov/nchs/icd/icd10.htm
 For regular CMS ICD-10 email updates, subscribe at:
 https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_608
 WEDI's Survey on Industry ICD-10 progress:
 http://www.wedi.org/docs/comment-letters/2013-wedi-icd-10-survey-results-letter.pdf?sfvrsn=0
 FREE CMS and WEDI ICD-10 End-to-End Testing Webinars available for download:
 http://www.wedi.org/forms/meeting/MeetingFormPublic/view?id=220AC00000156
 HIMSS/WEDI National ICD-10 Pilot Program Update:
 http://www.himss.org/library/icd-10/national-pilot-program?navItemNumber=13477
Though not inclusive, the following list includes several public websites that can help increase general awareness
and understanding of the ICD-10 mandate and its impact to the health care industry:
The links below were referenced during this presentation. The actual URLs below are provided for your convenience:
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Open Line Friday: ICD-10

15. Addendum
Cesar Ortiz, MBA, FACMPE
Cesar Ortiz is the Chief Executive Officer of PrimeHealth Physicians, LLC. Most
recently, Cesar directed and managed physician practices for Tenet Florida Physician Services and
HCA Physician Services. Previously, he was the Vice-Chair for Administration for the Department
of Otolaryngology and Urology at the University of Miami, Miller School of Medicine.
Cesar graduated from Miami-Dade College as a Respiratory Therapist working directly with patients
and physicians. He has a Bachelor‟s degree in Health Services Administration from Florida
International University and a Master‟s Degree in Business Administration from the University of
Miami.
Cesar has dedicated his professional career to the advancement of the professional management
of physician practices. He is one of the elite members of the Medical Group Management
Association to achieve Fellow Status through the American College of Medical Practice Executives.
He currently serves on the national board of the Medical Group Management Association. He is a
past-President of the Florida Medical Group Management Association and is co-founder of the
South Florida chapter. Cesar has authored and published articles and peer review journals related
to the field of medical practice management and taught at Barry University‟s Master of Health
Services Administration Program.
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Open Line Friday: ICD-10