Edifecs Aims to Remove the Financial Risks from ICD-10 Transitions
Today, at the Healthcare Financial Management Association National Institute, Edifecs, Inc. released the next versions of Edifecs ICD-10 Impact Analytics and Edifecs ICD-10 Code Management. These software solutions enable healthcare organizations to make the federally-mandated transition to the new diagnostic code sets without negatively impacting their operations or bottom lines.
The transition to ICD-10 is expected to impact nearly every business process within a healthcare provider organization, including scheduling, referrals, clinical documentation and coding, submission of claims, and reports. As provider organizations are preparing for the transition, it is critical that they are able to map ICD-9 codes they currently use to ICD-10 alternatives. Crosswalks and maps are code relationships that can help identify areas of greatest risk, which can be used to effectively prioritize remediation activities. Further, code crosswalks and maps may also help adaptation of business processes, systems and reporting for the ICD-10 transition.
Edifecs ICD-10 Impact Analytics and Edifecs ICD-10 Code Management solutions reduce operational and financial risk through self-service tools that quickly identify revenue variances and code shifts with the highest complexity. By focusing remediation resources on the areas of greatest risk, healthcare organizations can address the equally critical challenges of reducing costs and mitigating risks of the ICD-10 transition.
“We understand that ICD-10 is a highly burdensome mandate placing strains on the healthcare industry – with the business implications as a top concern. These solution enhancements will enable our healthcare provider partners to target necessary remediation actions by gaining insight into high risk ICD-9 and ICD-10 code shifts,” said Deepak Sadagopan, general manager of clinical solutions and provider sector at Edifecs. “They eliminate financial uncertainty and allow providers to take precautionary measures to assure continuity of expected revenue after the transition.”
Greater Level of Detail into the Financial Impact to the Business
One of the biggest ICD-10 transition challenges for provider organizations will be quantifying the likelihood that a facility, specialty, or whole enterprise is likely to lose or gain revenue. Edifecs ICD-10 Impact Analytics utilizes standard and custom maps and crosswalks to model all possible ICD-9 to ICD-10 mappings and pinpoints those that pose the greatest risks at different levels of the organization, and with each payer contract. This deeper level insight into the root causes of revenue variance identifies remediation actions that should be taken in order to minimize or eliminate them altogether.
Once provider organizations have identified revenue variances that pose the greatest risk to the business’ top line, collaboration with trading partners will be necessary to ensure that the goals of financial neutrality are addressed. For example, providers can undertake collaborative testing with their key trading partners. Collaborative testing reduces additional operational and financial risks by quickly and consistently comparing large volumes of test results between ICD-9 and ICD-10 data, helping organizations maintain optimal business outputs through the transition.