Friday, September 2, 2011

6 Questions & Ideas about ICD-10 Testing – For Payers & Providers

1. Have your vendors and trading partners completed testing with other firms like yours? Especially those that use your same software version? Will these vendors share their results with you? Can you fast track your pathway to comfort by understanding and leveraging the outcomes of those testing efforts? For both unit and end-to-end testing?
{Try to minimize work reinventing anything that looks like a wheel; take a piggyback ride instead!}
2. What are the possibilities for collaborating with other firms like yours who use the same software, clearinghouse and other 3rd parties?  Can you split up the knowledge, effort and share results?
{User groups and associations may be able to assist.  And ‘competitive concerns’ may be negated via virtual partnerships with firms outside of your market.)
3. What options might you want to work out with your clearinghouses regarding handling claims coded with ICD-9 AFTER the implementation date?  Reject them at the clearinghouse? Or pass them through and reject them yourself? If the clearinghouse rejects it, your trading partner may not be aware of and know details of the claim.
{Rejection is not always an undesirable thing – at least, maybe during the transition period.}
4. What’s your escalation procedure going to be for your “partners” who’re not being cooperative or are’nt sharing your same level of concern and/or not meeting your timelines?
{Bumps and problems with partners will occur – think about how you’ll address these inevitable scenarios before they occur.}
5. Certain applications are used across multiple business domains and ultimate responsibility is not always clear. It would be optimal to have a single contact/owner for each application.
{Avoid that classic saying: ‘No one knows what the problem is, but everyone knows who’s responsible for it!}
6. Explore your options for being able to easily compare results from ICD-9-coded transactions with ICD-10-coded transactions - so you can focus on failed test cases.
{Remember the goal: Ease of compliance and maintaining financial neutrality and operational neutrality!}
Simple ideas, eh?  Check back later for more tips, ideas and comments.

1 comment:

  1. "Collaboration Is Misunderstood and Overused"

    http://blogs.hbr.org/cs/2011/09/collaboration_is_misunderstood.html

    From Harvard Business Review

    Via ShimCode ...Who can't even comment on his own blog! :')

    ReplyDelete