Healthcare Solutions

As healthcare entities move toward compliance with the Federal ICD-10 mandate, they face a significant challenge. 

While it’s easy to see there are some considerable differences, the thing keeping most business and IT leaders awake at night is what they don’t know about how ICD-10 will impact their specific business. For example, where are the most significant impacts likely to be? How will reimbursement be affected? What specific codes are providers most likely to bill? And here’s a big one: how do we prioritize our efforts to make the best use of our resources? 

Maybe the question you should be asking is, “What if …?” 

What if you could gain insight into your business and precisely determine where the significant impacts will be? What if you could identify where the most dollars are being spent and how they will be affected by the complexity of ICD-10? What if you could analyze which providers are billing codes with the most multifaceted relationships in the new code set? What if you could understand which areas will be most impacted by reimbursement variances? 

Edifecs understands these challenges. In reviewing more than a half a billion ICD-9 codes in healthcare claim transactions, we know that more than 30% have complex relationships in ICD-10. That’s why we developed a complete solution to help you prioritize your effort and mitigate the risks associated with ICD-10.

Edifecs ICD-10 Impact Analytics enables healthcare entities to identify ICD-10 impacts based on their historical data. This is a critical first step toward understanding the challenge and determining how to address the ICD-10 mandate. For example, Edifecs ICD-10 Impact Analytics can identify which providers are billing codes today that will have significant complexity in ICD-10. You may want to work more closely with these providers and perhaps even involve them in early 

testing. With ICD-10 Impact Analytics, you can quickly zero in on the areas of greatest complexity and reimbursement risk to prioritize your remediation efforts. You can use this prioritization in Edifecs ICD-10 Code Management to assign code modeling and mapping. ICD-10 Impact Analytics also tells you which codes comprise the greatest percentage of your billing, and therefore, where you should prioritize your effort. And it provides a basis for test data for easy import into Edifecs ICD-10 Test Management. You can even identify which providers you should partner with on early testing efforts and determine how your existing policies may be impacted.

Make no mistake: ICD-10 is complex.

If you can’t identify your risk factors and figure out how to mitigate them with the resources you have, you could be losing sleep long before the deadlines arrive. On the other hand, Edifecs ICD-10 Impact Analytics can eliminate the unknown and set you on a user-friendly fast track to your ICD-10 implementation.