Responding to ICD-10: Healthcare Payer Strategy to Achieve Regulatory Compliance and ROI

Author:

Amy Schlom, Jordan Battani

This white paper provides an overview of the upcoming regulatory requirement for healthcare payers to adopt ICD-10. Healthcare payers will be required to upgrade to ICD-10 diagnosis and procedure codes to replace version ICD-9 in HIPAA transactions. A proposed regulation by the U.S. Department of Health and Human Services would mandate an aggressive implementation timeline of three years. Compliance poses a significant technical challenge for healthcare payers; however, there is real business value in ICD-10's potential to provide richer information about member health status and services.

The challenge for the industry will be to make changes to business processes that take advantage of the richer information available with ICD-10. This white paper discusses costs and potential gains to healthcare payers of ICD-10 implementation, as well as a recommended work approach to achieve compliance and optimize benefits.

Download "Responding to ICD-10: Healthcare Payer Strategy to Achieve Regulatory Compliance and ROI" (PDF, 151KB)

For more information, please contact us.