Miscellaneous Ideas and Thoughts Shared by Participants
1. Need to establish best practices for Medical Policy Remediation.
2. Recommends conveying what's in it for providers. Payers need to show providers a benefit to get them on board.
3. Recommends developing a crosswalk, crosswalk analytical tool and payer coordination since some won't meet date.
4. Establishing an enterprise-wide collaboration and using a consistent methodology are key.
5. Good testing strategy is based on risk analysis of historical claims.
6. ICD-10 can't be implemented the same way as past projects. Collaboration is critical.
Comments from Payer-Provider Collaboration Panel
1. ICD-10 delay will cost payers more money. Hard to keep momentum if official delay occurs.
2. Key learning need: ICD-10 constructs as important as actual code values - surprising to @Humana
3. Need to define how to measure neutrality and whether it's a viable goal.
4. Noted importance of analytics in modeling DRG shift.
5. What direction will CMS take with ICD-10 delay? Thinks a straight-out delay will occur.
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