Implementing healthcare reform measures impact every aspect of healthcare operations. In January 2009, HHS published the proposed rule mandating all U.S. healthcare providers to migrate to ICD-10 medical diagnosis codes by October 1, 2013. However, to be ICD-10 compliant, organizations must also have transitioned from the Health Insurance and Portability and Accountability Act (HIPAA) 4010 […]
Regulatory Compliance
Opportunities Abound: How to Leverage Increased Data Granularity in the ICD-10 Code Set
Join Perficient for our September 15th webinar, “Opportunities Abound: How to Leverage Increased Data Granularity in the ICD-10 Code Set” Migration from the ICD-9 to ICD-10 code sets is one of the most extensive and risky conversion projects healthcare insurers will face. Conversion will impact organizational structure, business processes, healthcare policies and IT systems. The […]
ICD-10 Migration Approach: Systems Remediation
Healthcare Payers must determine all business processes and applications impacted by the change to ICD-10. Applications that capture, store, send, receive, or edit diagnosis or procedure codes must be modified. Fields must support alphanumeric characters and expanded to support an extra digit. The new specificity of IDC-10 codes will impact corresponding application logic, business rules, […]
How The Accounting and Health IT Geeks Solved the Healthcare Cost Crisis
How’s that for a future headline? Earlier this week, a coworker passed along a link to an article with a rather bold title, “How to Solve the Cost Crisis in Health Care“. This article was written by world-renowned Harvard strategists Kaplan and Porter who are best known for the Balanced Scorecard and Five Forces, respectively. […]
ICD-10 is the Whole Enchilada
A quick and dirty news search of “ICD-10” reveals that in the past month over 140 news articles were posted referencing ICD-10. Why the continued hype about a conversion that is a little more than two years away? The answer is – ICD-10 is a serious feat and requires a substantial outlay of time, effort […]
ICD-10 Migration Approach: Data Impact Assesment
While 5010 has taken a backseat to ICD-10 in the media, payers must still meet the change to 5010 on January 1, 2012 before implementing ICD-10. Version 5010 accommodates the ICD-10 code, and must be in place first before the changeover to ICD-10. ICD-10 codes must be used on all HIPAA transactions, including outpatient claims […]
Can the Healthcare Industry create a Society that No Longer Bowls Alone?
There was a provocative blog published that linked prescription non-adherence with beliefs, trust and lack of communication. As I read through it, my mind thought of two things: 1. Robert Putnam’s classic publication Bowling Alone and the importance placed on trust to create social capital, and 2. the Advocacy Coalition Framework’s role of beliefs. According […]
ICD-10 Migration Approach
The migration from the ICD-9 to ICD-10 code sets is one of the most extensive and risky conversion projects Healthcare Insurers will face. Conversion will impact organizational structure, business processes, healthcare policies and IT systems. The scope of this change presents significant risks to Insurers seeking to achieve financial and benefit neutrality to avoid undermining […]
High-cost Patients, High-Tech Solutions: Why Taxpayers Deserve ICD-10 Compliance
When the sickest 1-percent of patients are responsible for nearly 30-percent of healthcare costs (over $690 billion annually) everyone loses. Since millions of people will be joining Medicaid under the new healthcare reform, states must either be prepared to pay the price tag associated with high-cost patients or determine a better way to manage the […]
Don’t Drop the ICD-10 Ball in the Regulatory Deadline Juggle
We are at the AHIP Conference this week, which is one of our favorite events of the year. It is good fun to meet with the many tech-savvy professionals that make up the health insurance industry. This year we meet as many regulatory pressures and deadlines are closing in, which is certain to ignite some […]
Riding the ACO Reg Rollercoaster: Administration Offers New Path
Opinions and posturing on the Accountable Care model started well before the release of the proposed regs over a month ago. However, since their release those of us working within the healthcare industry have been riding the rollercoaster of public sentiment. The enthusiasm around the regs was immediate upon their release. Blogs, Twitter, and online […]
The IT-Enabled ACO
It’s all the rage. Everyone is talking about it and some have called it the next major healthcare reform to hit the industry over the past 20 years. So what is it you ask? It is the Accountable Care Organization model, more commonly dubbed the ACO. No doubt everyone has been reading, learning and commenting […]