Managed Care

 

Providers lag in ICD-10 readiness

MANAGED CARE September 2010. © MediMedia USA
News and Commentary

Providers lag in ICD-10 readiness

MANAGED CARE September 2010. ©MediMedia USA

In an ideal world, payers and providers would be on the same page when it comes to ANSI X12, version 5010 compliance and ICD-10 code readiness. But a recent survey conducted by the Healthcare Information and Management Systems Society (HIMSS) indicates that most providers will not be ready to test their electronic health information systems by Jan. 1, 2011. Only 38 percent report that they have an actual system and 35 percent report that they have no plans to implement one.

On Jan. 1, 2012, standards for electronic health care transactions change from ANSI version 4010/4010A1 to version 5010. These electronic health care transactions include functions like claims, eligibility inquiries, and remittance. Unlike the current version 4010/4010A1, version 5010 accommodates the ICD-10 codes, and must be in place before the changeover to ICD-10.

It’s unlikely that providers will be able to make up ground to meet the January deadline, according to the survey. Providers also report difficulties in finding knowledgeable staff and vendors who are ready for the transition.

In June 2010, providers reported only limited progress on 5010 compliance
Do not expect to have a 5010 project started before the end of 2010 33%
Haven’t even started an impact assessment, the first step in preparing for 5010 40%
Have an approved budget 21%
Started contacting vendors 15%
Have yet to consider 5010 planning 35%
Plan to upgrade existing system 74%
Plan to replace existing system 9%
Source: HIMSS 5010/ICD-10 Industry Readiness Survey

Meetings

Pharmaceutical Pricing and Contracting Conference Philadelphia, PA September 22–23, 2014
Private Health Insurance Exchanges Conference Washington, D.C. October 7–8, 2014
National Healthcare Facility Management Summit Palm Beach, FL October 16–17, 2014
National Healthcare CFO Summit Las Vegas, NV October 19–21, 2014
National Healthcare CXO Summit Las Vegas, NV October 19–21, 2014
Innovative Member Engagement Operations For Health Plans Las Vegas, NV October 20–21, 2014
4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014