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Customer Experience and Design

2011 AHIP Conference Trend Watch

The 2011 AHIP national conference is almost here. Our team will be out in San Francisco for the June 15-17 event. With all of the changes we are witnessing in the health insurance industry, this year’s conference promises to address the many needs of conference attendees. Whether it is meeting regulatory compliance issues or preparing for health insurance exchanges, the AHIP conference will be the place to be this week.

Participants should leverage the AHIP conference to attend many of their peer organization presentations to learn from personal experience. We look forward to visiting the exhibit floor to listen and observe what is being highlighted by the vendors as well as what our peers are saying and asking. Health insurance companies can use this information to formulate how to address important issues.

Most importantly, enjoy the educational and collaborative nature of this event and network with your colleagues and solution providers so you can see the potential that can be achieved. Take advantage of intelligence and expertise that will be found in San Francisco this week that will enable your health insurance system to be among the world-class organizations.

We would love to meet with you at the conference. Leave a comment, catch up with us in person, visit our AHIP page, or contact us on Twitter (@Perficient_HC) to discuss what you think the hot topics for health insurance are this year. Here is what we think:

UTILIZATION MANAGEMENT

Utilization Management (UM) is a process for assessing the delivery of healthcare services to determine if patient care is medically necessary, appropriate, efficient and meets quality standards.

  • Healthcare and BPMS Services: Streamline Payor’s UM processes for higher productivity, and faster turnaround
  • Rules Engines: Create and maintain flexible business processes to meet changing marketing and regulatory needs
  • SMART SOA: Can streamline the IT architecture and speed implementation of automated business processes
  • ECM Practice: Incorporate document management into your UM process to speed review
  • Healthcare Payor Knowledge: Bring value to the design of your UM solution

ICD-10 IMPLEMENTATION

Perficient’s ICD-10 solution begins with a phased roadmap of coordinated projects beginning with a careful analysis of your healthcare IT applications and ending with the cultural transition of using the expanded code set.

  • Impact Analytics: Automates the identification and visualization of relationships between ICD-9 in historical claims data and corresponding ICD-10 code matches with eight separate levels of complexity and risk.
  • ICD-10 Code Management: A medical ontology based code management system that allows modeling and mapping of ICD-9 codes into ICD-10 equivalents, and vice versa.
  • ICD-10 Test Management Automates the creation of large volumes of ICD-10 test data and shows the differences between results processed in ICD-9 and in ICD-10.
  • ICD-10 Code Translation A scalable, high-performance translation engine that enables ICD code translation (forward/backward)
  • ICD-10 Consulting Services: Provides expert support for the software toolset and services.

HIPAA 4010 TO 5010 CONVERSION

Perficient’s HIPAA 4010 to 5010 solutions are a full scope effort within your organization including:

  • Assessment: Identify the tools and technologies that best fit your environment. Clarify the benefits and opportunities you can expect. Define the people and process changes that will facilitate a 5010 upgrade program
  • Solution Roadmap: Define an actionable roadmap that clearly articulates the steps required for a successful upgrade. Align to business goals while mitigating risks.
  • Implementation: Execute this roadmap with a flexible project approach. We work in concert with your team to deliver results at lower costs than our competitors.
  • Business Process Improvement: Improve business processes for electronic data transactions (824 – application reporting, 820 – premium payments); transaction reprocessing and transaction management; new stricter enforcement of the HIPAA legislation; new regulations convert business associates as covered entities under HIPAA.

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David Hastoglis

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