ICD-10 Prep for Healthcare Payers - Sponsorships available

ICD-10 may be delayed, but it's not going away. Many have compared the scope preparations for the impending 10th revision of the International Classification of Diseases to the legendary Y2K ramp-up. But there's a key difference: the transition to ICD-10 affords the potential for a solid return on investment! Given that payer systems and business processes are closely tied to diagnosis and procedure data, reaping the return will require additional staff resources, as well as sweeping changes to technology and business operations. Getting up to speed won't come cheaply. Analysts predict that the ICD-10 implementation will cost healthcare payers between $378 million and $833 million, and will cost the industry as a whole between $1.6 billion and $13.5 billion*.

Healthcare payers can reap a return on investment with a carefully planned strategy that focuses on streamlined improvements to their clinical, IT and administrative operations. Strong leadership will be critical. Gearing up for this big change will require healthcare payers to scope and prioritize the necessary technical and business process changes.

This eBook, written by a seasoned healthcare journalist, will highlight the strategies that payers are using to prepare for this milestone change, including their processes for updating and/or overhauling their IT, business and operational systems and the critical leadership roles that will drive their success.

*Payer estimates by the 2003 Robert E. Nolan Company report for the Blue Cross Blue Shield Association; industry estimates by the Nolan Company and HHS.

Opening Commentary: The introduction will include an overview of ICD-10, including information about the delay, how it vastly expands upon ICD-9 and the cost-saving (and revenue-generating) opportunities it presents to the payer market. This section will also outline the regulatory requirements of the ICD-10 transition, including HHS' timeline and phase-in requirements.

System/IT challenges: This section will highlight the specific systems challenges posed by ICD-10 and how healthcare payers are meeting them. What changes are healthcare payers implementing to ensure that reports and applications that capture, store, maintain, receive, send or edit procedure or diagnosis data will be ICD-10 compliant? What are the most common snags they've come up against?

Operational changes: Payers can capitalize on the increased specificity of ICD-10 codes by reengineering key functions. This section will examine specific changes payers must implement with regard to reimbursement determinations; contract renegotiations; disease management programs, medical policies, pay-for performance programs, EOBs and other critical processes. What steps are payers taking to mitigate the impact on core claims systems, claims auditing, medical management, decision support and enrollment and underwriting systems?

Educating providers: Because ICD-10 provides much more specificity than the 9th revision, payers must educate providers in advance on how to properly crosswalk and code their claims during the transition. This section will include a discussion on how payers are working with providers to ensure they capture the most accurate diagnosis and procedure descriptions possible.

Other benefits include:

• Effective lead-generation tool that also allows you to demonstrate industry thought-leadership
• Provides a deep-dive on this timely issue for key decision-makers
• Educates the marketplace while generating highly qualified leads