ICD-10 Real World Examples

What 5010 Can Do for ICD-10

Annie Boynton BS, RHIT, CPC, CCS, CPC-H, CCS-P, CPC-P, CPC-I Director 5010/ICD-10 Communication, Adoption & Training 5010/ICD 10 UnitedHealth Group

Leverage 5010 Experiences

Work should be well underway for the upgrade to HIPAA Version 5010 HIPAA 5010 has garnered powerful lessons as we move toward overall ICD-10 implementation in the areas of:
Communications C i ti Training Trading Partner Testing g g Staffing Provider Readiness Must be finished by January 1, 2012.

The Numbers

HIPAA 5010 & ICD-10 Implementation at ICD 10 UnitedHealth Group:

90,000 employees that require some level of , p y q training 32 Functional Domains impacted 50+ Vendor Contracts impacted 750+ Applications (including 46 claim platforms) 70 million members

Communications

Staffing Concerns
Identify the right people
Coder, Communication, Project Management j g Why Outsourcing is not an appropriate solution Ensure Staffing levels

Identify the right vehicles right vehicles

Money need not be a significant issue Leverage existing communications vehicles Constant updates

No such thing as too much communication

Training

Begin Early

Recognize resource limitations

Identify Resources

Staff Appropriately
Tunnel vision

B d t f ICD 10 training will be vastly different Budget for ICD-10 t i i ill b tl diff t than 5010 Train the trainers Effectively communicate size and scope of ICD-10 Coders, Trainers, Project Managers Do not make SMEs trainers

Trading Partner Testing

Ensure intent of TPT plans are well voiced

Everyone needs to understand what testing will mean to them.
Set clear definitions & expectations

Staff appropriately
More than a 1-2 FTE job for operations h bf

Begin TPT Surveying as early as possible P t t k staff Protect key t ff

Ghost mailboxes

Staffing

Setting will have a large impact as to timing of staffing levels

Resource limitations

Providers/Facilities - May need significant additional staff resources to coverage for training and to account for productivity losses in 20132014 Payers Need significant additional staffing during implementation and back bench work Dont cost-save your organization into a corner Don t cost-save If possible plan for MORE staff than you think you will need

Provider Readiness

Shocking lack of awareness/preparedness in provider/facility communities

Recognize competing priorities Bring the impacts of procrastination to the provider Give ICD-10 a public face within the organization ICD 10

Seize Industry/Organizational Opportunities

Transform the relationship between payers and provider/facility communities d /f l Payer advocacy
Strengthen existing relationships g g p

Final Points

There will never be enough:

Time Money Resources Sanity

Regardless of setting waiting risks revenue in 2013 and beyond. It is important that ICD-10 planning begin now t make thi t to k this transition t ICD 10 iti to ICD-10.