ICD- 10 Migration.

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1 ICD- 10 Migration

2 Overview ICD-10 compliance is looming over all HIPAA-covered entities. By October 01, 2015, these entities need to adopt the 10th revision of the International Classification of Diseases (or ICD-10) for diagnosis and procedure codes, to successfully be able to conduct health transactions. What Should Healthcare Entities Do? As a first step to a seamless transition, you need to identify all ICD-10 touch points in your systems and business processes. Subsequently, you need to identify the needs, resources and training along with testing, with third-party entities like clearing houses. But there are challenges. Not only is the clock ticking, but because compliance is an unfunded mandate, there are budgetary constraints. (While the estimate was 0.03% of revenues, cost overruns have been the norm). Also, bandwidth is under pressure due to the need to keep up with healthcare initiatives such as meaningful use, 5010, and healthcare reforms among others. Most crucially, you could end up losing hard-earned revenue. The need of the hour, then, is a healthcare services specialist who can help you accomplish all this and more. ICD-9 had several limitations such as limited data about patient s medical condition and inpatient procedures.it was outdated, obsolete and inconsistent with current medical practices. It was no longer workable for processes pertaining to treatment, reporting and payment. The adoption of ICD-10 brings with it, several opportunities as well as challenges. For one the number of codes has increased from 17,000 to nearly 68,000 (for both diagnosis and inpatient procedures). Similarly, the code length has gone up from threefive digits to three-seven digits. This expansion means greater specificity and granularity. However, it also represents a massive overhaul of the current system of coding diseases and symptoms, as well as a new way of categorizing diseases and linking them to treatment options. ApexonHealth 2

3 The ApexonHealth Approach With a track record of helping the healthcare industry, ApexonHealth can help you navigate the complexities of ICD-10 migration by not only developing and reviewing your strategic approach and road map for implementation but also providing services necessary for compliance including IT system conversion, certified coders and training. The three pillars of ApexonHealth s ICD-10 migration services Technology Workflow Management: Batch prioritization, dashboards and alerts, provider education Conversion: ICD 9-10 Crosswalk, NAV-10 Computer Assisted Coding (CAC): Optimization, audit and automation Professional Services Consulting ICD-10 Coders Training Web-based Customizable ApexonHealth 3

4 ApexonHealth s ICD-10 Migration Approach & Conversion Services ICD-10 Impact & Gap Analysis Solution & Strategy Development ICD-10 Application Remediation Data Extraction, Conversion & Reporting Process Re-engineering to Support ICD-10 Verification & Validation ICD-10 Transition Management Consulting Services Training Identify current systems and work processes that use ICD-9, including clinical documentation, superbills and other clinical and administrative systems that need to be updated. Implementation requires changes to systems that capture and report diagnosis and procedure codes with the immediate opportunity due to the change in character length and the need to expand the data fields. The next step is to identify potential changes to existing workflows, business processes and reporting. Role-specific training is essential to ensure that your employees are knowledgeable about the ICD-10 code set and are well-prepared to start using the new codes appropriately. Key decisions here include which code sets are involved (ICD-10-CM used by physicians for diagnosis and/or ICD-10-PCS used by hospitals for inpatient procedures), personnel to be trained and format (web, classroom, train the trainer). The last and most essential step is testing with your trading partners with whom transactions are exchanged, like clearing houses. This will ensure that you are able to send ICD-10 transactions and also that they are received properly. ApexonHealth 4

5 ICD 10 Key Initiatives Training Dual Coding & Analysis Bench Strength ICD 10 Task Force Sr. Mgmt/BA/System Analyst/Ops/Trainers Train the Trainer Program AHIMA ICD 10 Training Program Monthly Training Calendars Three-phased Training Introductory Intermediate Advanced Professional Certifications of Coders Parallel Coding on both ICD 9 & ICD 10 by trained coders System Impact Analysis Identifying Workflow Deficiencies Proposing Changes Documentation Improvement Analysis and Physician education Revenue Impact Analysis 100% of client s coding staff will be trained and ready for ICD-10 Pool of additional coders to be assigned for off-setting any loss in hourly production ApexonHealth will have trained ready reserve dedicated for ICD-10, available to begin coding from October 1, 2015 Why ApexonHealth A focused healthcare specialist with 25 clients and a track record of offering consulting, technology implementation and certified coders. 12 Million Plus charts coded annually with a 98.5% DPMO level of accuracy Experienced senior management and professionals with in-depth understanding of healthcare business processes Members of AAHAM, AHiMA, HBMA, HFMA and American Academy of Professional Coders Standards benchmarked against ISO27001, HIPAA and HITECH Act guidelines Well-defined activity plans ensure availability of people, processes and technology as required by the compliance implementation plan ApexonHealth 5

6 ICD-10 promises to open a world of new opportunities and benefits fewer rejected claims, refinements in reimbursement models, minimization of billing fraud, increased specificity, specific data leading to better data for reporting and improved benchmarking. Contact ApexonHealth today for a risk-free consultation and more: Gap analysis, risk and impact assessment (especially financial) Software consolidation and IT system conversion Third-party testing Training and change management ICD-10 coders Dual coding support for ICD-9 and ICD-10 during crossover Process improvements About ApexonHealth ApexonHealth is the healthcare division of Technosoft Corporation. The company provides AI-driven solutions for healthcare Providers, Payers and other healthcare organizations leveraging our proprietary Newton AI Digital Transformation Platform. Newton AI combines machine learning, Robotic Process Automation (RPA) and Business Process Management (BPM) to help customers to reduce costs, improve cash flow, and increase customer satisfaction. ApexonHealth is headquartered in Southfield, MI and has certified service delivery centers in the US and India. With over 12 years of healthcare experience, ApexonHealth is trusted by dozens of Fortune 500 clients and is an active member of HFMA, HBMA, AHIMA, AAHAM, AAPC, MGMA, AHIP and CISA. Visit One Towne Square,6th FL, Southfield, MI 48076, Phone: Copyright 2018, ApexonHealth. All rights reserved. No part of this document may be reproduced, stored in a retrieval system, transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the express written permission from Apexon. The information contained herein is subject to change without notice. All other trademarks mentioned herein are the property of their respective owners.

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