Health Information Management

Tip: Assess payer readiness before ICD-10 implementation

APCs Insider, June 5, 2015

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Provider/payer integration is essential for successful ICD-10 implementation. Contracts will need to be evaluated early on, and a collaborative approach will be ­conducive to assessing, evaluating, and translating terms and, ultimately, reaching an agreement.
Payer readiness and strategic approaches must be well understood by providers. While payers must accept claims in ICD-10 October 1, 2015, their approach may vary. Some may have all systems and functions ICD-10 ready. Others may employ alternative approaches using translations and mappings. An offensive approach will be to collaborate, gain insights into the planned approach, and model accordingly.
Your organization's ICD-10 steering committee should assign a sub-group to manage the task of contacting and surveying transition plans. The provider-payer relationship is collaborative and must include attention to every detail. Take a proactive approach and meet with payers in advance of implementation to assess readiness and continually compare notes on how you are jointly preparing for the transition.
This tip is adapted from “ICD-10 implementation requires organizationwide education and awareness" in the June issue of Briefings on APCs.

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