Client Challenges Today
Healthcare payers are facing two major compliance initiatives: conversion from the HIPAA 4010 to 5010 electronic transaction set and conversion from ICD-9 to ICD-10 code sets. These initiatives are expected to impact nearly every core process, system and interface across the healthcare industry. Healthcare organizations must decide how to spend scarce resources over the next few years. Estimates suggest that less than 30% of the work involved in HIPAA 5010 and ICD-10 conversions will be handled by core application system vendors. This leaves a huge effort to be undertaken internally by business and IT professionals. Few organizations will be able to meet the mandated compliance deadlines without outside assistance.
Solution and How We Work
Capgemini’s approach to HIPAA 5010 and ICD-10 conversions is based on our experience developing IT and BPO solutions for the healthcare payer and provider sectors. While the complexity of conversion will differ by organization depending upon the number, type and flexibility of the affected processes and systems, our approach provides a roadmap to successfully meeting deadlines and seizing opportunities for organizational improvement.
From the initial assessment phase through implementation and beyond, Capgemini can help with your HIPAA 5010 and ICD-10 conversion to ensure a smooth transition. We can also assist in defining business intelligence and analytical capabilities to leverage the granular data received as a result of ICD-10 coding.
We follow a proprietary, rigorous approach to conversions that follows four project phases. For HIPAA 5010 conversions, the phases are: assessment; design and mapping; customization, integration and testing; and documentation and knowledge transfer. For ICD-10 conversions, the phases cover pre-planning and impact analysis in addition to customization, integration and testing, and documentation and knowledge transfer.
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