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Focus Area: ICD-10
Many healthcare organizations are beginning to grasp the full impact ICD-10 compliance has on health plan operations, clinical services and technology. In most cases all processes/work flows, systems/technology, coding, clinical guidelines, reports and interfaces must be researched and modified to comply with ICD- 10 standards. The impact of ICD-10 is truly pervasive throughout the entire health plan enterprise. Health Plans are required to address ICD-10 not only for compliance with HIPAA regulations but also to maintain a competitive position in their markets. Our ICD-10 expertise, methodology, and tools facilitate the identification of all impacts of ICD-10 and support the efficient planning for implementation and compliance. We support ICD-10 remediation with the following services:
- Deliver 5010 and ICD-10 education and training workshops
- Perform 5010 and ICD-10 impact assessments to identify changes required throughout business, technology and clinical services to determine and roadmap for implementation and compliance.
- Efficient planning and implementations of interventions to ensure compliance for both 5010 and ICD-10
Our engagements result in:
- Significant reductions in expense by consolidating applications/systems and streamlining processes
- Shortened or eliminated "Flying Blind Period" through use of precise ICD-10 data for setting fee schedules and premiums and early movement to outcome reporting and pay-for-performance thereby reducing financial risk
- Improved chronic care management and medical loss ratio by utilizing ICD-10 to work with providers of care
