icdone migration to icd-10 · with the icd-9 code set crossing over 30 years and becoming outdated,...
TRANSCRIPT
< Accuracy and increased efficiency in:0 Claims payment and processing due to better
mapping specificity leading to improved provider
network contracting.0 Data analytics and reporting processes; especially
with respect to drug utilization and
reimbursement 0 Medical pricing, by utilizing the appropriate
decision rules
< Reduction in:0 Number of appeals and grievances owing to
granularity of data and payment hierarchy0 Cost of implementation due to our investments
in creating automated tools and solutions0 Duration for implementing ICD-9 to ICD-10
conversion while leveraging the existing
architecture and guidance from our healthcare
subject matter expert
< Prevention and detection of healthcare fraud
and abuse
< No dependency for the readiness from
external vendors and claims clearing houses in
conversion
With the ICD-9 code set crossing over 30 years and
becoming outdated, the conversion to ICD-10 has
become a mandate due to ICD-9’s limitation to
accommodate new diagnosis and procedure codes, and
the final rule has set forth a compliance date of October
1, 2013. ICD-10 allows over 14,400 codes and also
facilitates tracking of many new diagnoses. However,
such factors like the increase in number of codes, change
in the number of characters per code and higher
specificity are making the migration to ICD-10 complex.
The transition will require significant planning and
upgrades along with huge investments.
Understanding the complexity and investments involved
in the transition, L&T Infotech has designed an innovative
framework to simplify the process while paying equal
attention to the risks involved. Our suite of services help
healthcare providers, payers and clearinghouses / third-
party billers deal with the migration process well before
the compliance date and with minimal disruption.
<
<
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Data standardization prior to and after ICD
conversion to handle reimbursement and mass claim
adjustment
Technology enhancement – handling conversion
during the claims adjudication process within the
SLA limit
Resource and budget constraints
Business Challenges of Health Industry
Migration to ICD-10
TMICDone
“A complete solution towards the ICD-9 to ICD-10 conversion challenges”
Improved DiseaseManagement Business Process
Improvement
Fraud Detection &Prevention Medical Pricing
Accuracy
Key Benefits
Business Benefits
*ICDone is a trademark of L&T Infotech
ICD-10 Governance Model
Governance Model
¡ Business Process Consulting
¡ Technologies Enhancements
¡ Assessment & Gap Analysis
¡ Documentation and Financial Risk Analysis
¡ Information System Selection and Implementation
¡ Advisory Services
¡ Business TechnologyValidation
¡ Compliance & Statutory Validation Services
¡ Business Process Testing
¡ Functional Regression Testing
¡ Conversion Testing
¡ Conversion0 Mapper0 Impact Analyzer0 Remediation
¡ Legacy Decommissioning
¡ Business RoadmapDevelopment
¡ Program MonitoringFramework
Services & Offerings
Consulting Remediation Solutions
Verification & Validation
Service Offerings
Tools & Technology CoE
Domain & Partnership Knowledge Management Capability
Innovation CoE
About L&T Infotech
www.Lntinfotech.com Email: [email protected]
Business-to-IT Connect
*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 L&T Infotech.
Larsen & Toubro Infotech Ltd. (L&T Infotech), one of the fastest growing global IT services company, is ranked by NASSCOM as the 6th largest
software & services exporter from India and among the top 20 IT BPO employers in 2014. It is a wholly-owned subsidiary of Larsen & Toubro
(L&T), a multi-billion conglomerate, and India’s largest Technology, Engineering, Construction, Manufacturing and Financial Services
organization, with global operations.
L&T Infotech is differentiated by its three-pronged value proposition, encompassing Business-to-IT Connect, Execution Excellence and Engage
the Future. (www.Lntinfotech.com)