ICD-10 transition has several impacts that many health plans and health care providers will not consider, unless they are doing a comprehensive assessment of all systems and processes. If ICD-9 diagnosis coding (ICD-9 CM) and ICD-9 procedure codes are included in the workflow.
Since most of the cost containment and settlement solutions vendors do charge the plan, this actually works against the health plan's ability to manage their expenses and comply with regulations. Health plans should look to solutions that support the MLR calculation and regulations, and maximize the speed and the amount of reimbursement to the provider.
Delaying ICD-10, AMA believes will help preserve its relevance, and its control over physician compensation. Sadly it seems that AMA hasn't served its own members well, or the healthcare industry. ICD-11 won't "arrive" in a year or two. Our health system needs to digest it and then determine when and how to move to it. While ICD-11 has some intriguing benefits, it is a long way off. The base version from WHO is expected in May 2015. After that, the United States will probably need another two years for development of the US version. The earliest it would be available for study would be 2017, and we would need another 4 years to implement it – so that brings us out to 2021, way too far in the future.
HIPAA 5010 and ICD-10 implementation timelines were published as widgets for payers, large providers, small providers and vendors by Health and Human Services Centers for Mediare and Medicaid (CMS). There are helpful items such as actions to take immediately, for HIPAA 5010 and more regarding ICD-10.
Here is a summary of lessons learned from the Canadian experience with ICD-10 implementations and also importantly where the two implementations differ.
This is a first step toward implementation of an Affordable Care Act provision that cuts red tape in the health care system. HHS estimates this will save $12 billion over ten years. Whether a patient is eligible for coverage The status of a health care claim submitted to a health insurer
on November 22, 2010 the Obama Administration's regulation implementing new standards for the “medical loss ratio” provision of the Affordable Care Act will make the insurance industry more transparent and is intended to enable consumers to purchase health insurance that provide more value for every dollar paid for premiums.
Although no official word has been handed down regarding exactly what fines our federal government may slap against healthcare organizations that fail to comply with HIPAA 5010 or ICD-10, it appears likely that there will be fines, and they will be sizable. via Concern persists for HIPAA 5010, ICD-10 non-compliance fines | Healthcare Finance News.
No World Borders believes that the clock is ticking on important implementation deadlines for electronic health care and claims compliance dates, and these changes only delay that process. Many health care companies are still asking “What is HIPAA 5010” when they should be asking “how fast can we implement HIPAA 5010.” The new EDI standard enables improved data and provides the foundation for the ICD-10 medical coding standard. These two initiatives have important implementation milestones. See www.noworldborders.com for more information on our home page.
Atlanta conference February 18th will cover both the data interchange standard HIPAA X12 5010 and the companion medical claims coding standard ICD-10. Over 20 industry experts from leading health consulting and technology solutions firms will be participating.
process, organizational readiness, and IT alignment with business are as important as the 4010a to 5010 gap analysis and system integration. Mike Arrigo slides
On Monday, November 30th at 1pm ET Mike Arrigo, CEO of No World Borders, Inc. will be participating in a health care industry panel on health care, HIPAA 5010, electronic data standards and some specifics around implementing the EDI standard HIPAA 5010. His talk will include An Introductory Overview of the HIPAA 5010 [...]