The deadline for ICD-10 implementation is fast approaching and healthcare Payers and Providers have less than two years to meet the requirements. Some healthcare organizations have yet to initiate their plans for the migration, some have progressed at a slow pace and very few have made substantial commitment to completion.
Payers on track with the ICD-10 implementation process should have completed the Risk/Impact assessment of their IT and business areas and started their planning activities. Based on our experience with previous HIPAA implementations, we believe there are a few areas that healthcare organizations need to consider to ensure success of their ICD-10 migration program. Highlighted below are five mistakes Payers should avoid.
- Receipt and Processing of ICD-10 codes – While Payers weigh in on the advantages and disadvantages for a partial remediation, more importance should be given to long term strategies. Going in for full remediation allows organizations to reap all the benefits of ICD-10 implementation. It is important to avoid falling into the trap of less risky partial remediation.
- ICD-10 Benefits for Customers – Payers should avoid viewing ICD-10 implementation as another healthcare mandate created to increase the cost of healthcare. They should look from the perspective of a member and educate the members on the benefits of ICD-10. This ensures more member retention and satisfied customers.
- Implementation Approach – Most CIOs focus on ICD-10 implementation as another IT project and miss out on the key areas of improvement. Considering BPM as an implementation tool will engage businesses more and make them feel part of the implementation success.
- Tool Selection – Avoid selecting a tool with inadequate test data capabilities. The tool has to be flexible enough for the business team to use. Remember: the tool will primarily be used by the business and not by IT. This approach will also ensure quick adaption to the tool and avoid frustration associated with quality of the test data.
- Test Strategy – More than any other HIPAA implementation, ICD-10 provides a huge challenge for testing. Our experience indicates that the testing aspect of the migration is not given due importance. Test data creation should be of highest priority to ensure coverage of test scenarios. Having a separate vendor specialized in healthcare testing will help the team focus more on the business, rather than technical, goals and objectives.
HIPAA implementations provide us with important insight into the various elements of a successful migration program in the healthcare industry. Above are a few of the traps which Payer organizations should avoid as they progress in their ICD-10 journey. We believe these mistakes, if prevented, can positively impact the timelines, efforts and costs of their migration program. We are curious to hear other challenges and issues you have come across which have critically influenced HIPAA / ICD-10 implementation programs. Please share your comments below.