5010 & ICD-10 Readiness Services
What can Oleen Pinnacle bring you?
Oleen Pinnacle provides services designed to prepare you for how to leverage the 5010 and ICD-10 mandate and minimize your exposure and operational risks. These services include comprehensive assessments, planning, and system remediation and optimization.
When you partner with Oleen Pinnacle to provide 5010 and ICD-10 services for your organization, you will achieve:
HIPPA 5010 Compliance
HIPAA 5010, or 5010 for short, refers to the new file format standard for electronic data interchange (EDI) transactions that are submitted and received by providers, health plans, and plan employer groups. The existing 4010A1 format is being replaced to accommodate the longer, alpha numeric ICD-10 codes and the additional information that will be collected and transmitted in order to process health claims. 5010 is the foundation for future changes affecting the US healthcare industry; not the least of which is the migration to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for diagnosis coding, and the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) for inpatient hospital procedure coding.
Oleen provides services designed to maximize the business opportunities and minimize your exposure and operational risks. These 5010 services include Readiness Assessments, Conversion Project Management, and System Remediation.
- Readiness Assessments – Provides your organization with management information from which decisions can be made. Estimated assessment duration is 2 – 4 weeks, depending on the complexity of your organization. Assessment deliverables include: documented evaluation of conversion requirements; systems affected by the 5010 conversion; resource readiness; preliminary budget; and risk assessment that identifies areas of exposure.
- Conversion Project Management – Experienced project manager that understand the ARRA/HITECH requirements, risk, timelines, and process for ensuring all required tasks are completed as required.
- System Remediation – After the affected systems are identified, action must be taken to complete the conversion activities, test the interfaces, and validate the results. Our experienced teams can work with your vendors and/or developers to complete and test the interface changes. The revenue cycle team will also work with your business office to reconcile claims transactions.
ICD-10 Migration
ICD-10 adoption will enable more comprehensive and accurate coding of clinical documentation, provide more comprehensive capabilities to report patient care data, and increase the value of clinical analytics by providing highly specific diagnosis and treatment information. The migration affects both the financial and clinical systems including medical coding that drives clinical outcomes and the revenue cycle, quality indicators, patient education, reimbursement based on contract terms. Upgrading to ICD-10 will provide your organization better data for measuring health care service quality, safety, and the efficacy of care while allowing clinical IT systems to record far more specific and rich diagnostic information that will boost efficiencies by helping to identify specific health conditions.
Preparing for this all-encompassing requires organizational wide planning beginning with an assessment of the current state from which a plan of action that drives your efforts can be developed. Our experienced teams of consultants are ready to help you evaluate the future benefits and current impact of ICD-10 and how you strategically plan for this change. These ICD-10 services include Comprehensive Benefit and Impact Assessment, Project Management, and System Remediation and Optimization. Although this move to ICD-10 codes appears to be daunting, it will provide the path towards more accurate payment for services as well as provide the granularity that government services and commercial payers need to conduct more meaningful analyses of diagnoses and procedures as related to performance based outcomes and costs.
- Comprehensive Benefit and Impact Assessments – Will enable the organization to initiate required steps necessary to gather and organize information required to successfully maximize and manage the ICD-10 migration. Estimated assessment duration 8 – 12 weeks, depending on the size and complexity of your organization. Assessment deliverables include: documented evaluation of conversion requirements; inventory of systems affected by the ICD-10; revenue impact assessment; required project resources; preliminary budget; and risk assessment that identifies areas of exposure.
- Migration Project Management – Experienced project manager that understand the ARRA/HITECH requirements, risk, timelines, and process for ensuring all required tasks are completed as required.
- System Remediation and Optimization – After the identified phase, the technology and procedural conversion activities begin. Our experienced teams will work with your internal departments and external vendors to ensure all technology systems and interfaces are successfully accomplished parallel to working with the clinical and financial departments to ensure smooth transition.