Sep 01, 2009
Download Healthcare payers and providers are facing two major compliance initiatives over the next couple of years: conversion from the HIPAA 4010 electronic transaction set to the 5010 set and conversion from ICD-9 codesets to ICD-10. These initiatives will impact nearly every core process, system and interface across the industry, and industry costs are expected to be in the billions of dollars. Although compared by pundits with the Y2K initiative, the twin HIPAA 5010 and ICD-10 conversion initiatives will be much more time-consuming and complex. Moreover, these conversions come at a time of intense financial and personnel resource competition within the healthcare payer industry. Patni has significant experience in developing IT and BPO solutions in the healthcare payer and provider sectors. Patni has utilized this expertise to develop its approach to HIPAA 5010 and ICD-10 conversions. This paper details the issues and costs of conversion and outlines Patni's framework for planning and executing these initiatives. While the complexity of conversion will differ by organization depending upon the number, type and flexibility of affected processes and systems, the Patni approach provides a roadmap to successfully meeting deadlines and seizing opportunities for organizational improvement.