DST Health Solutions LLC announced its 5-I Compliance Accelerator Program, designed to help health plans successfully prepare major business systems for compliance with upcoming federal regulations.
Within two years, the Centers for Medicare & Medicaid Services (CMS) will require healthcare organizations to begin using new standards for electronic transactions and within three years new diagnostic and procedure code sets – a regulatory challenge being dubbed "healthcare’s Y2K."
The current diagnostic coding system, ICD-9, is limited and no longer reflects current medical conditions. CMS will require new ICD-10 codes for all HIPAA transactions by October 1, 2013, to ensure data compatibility nationally and internationally. Also, the standard for electronic healthcare transactions is changing on Jan. 1, 2012 from Version 4010/4010A to Version 5010, to accommodate new ICD-10 codes and improve the transactions.
"When I looked at the calendar, and the amount of customization we have, I wanted to have the appropriate amount of time to ensure a successful transition to 5010 and ICD-10," said Jerry Queen, IT Director of Amisys Environment Systems at ConnectiCare, Inc., a health plan based in Farmington, Conn. "DST Health Solutions’ strategy and the timing of its 5-I Compliance Accelerator Program allows us to be successful in our transition to 5010 and ICD-10, and perform custom coding of ConnectiCare applications and other technology adjustments required in advance of these mandates."
DST Health Solutions’ four core claims administration systems – AMISYS Advance, PowerMHC, PowerMHS and PowerSTEPP – are all on schedule for a 5010-ready release in advance of the CMS deadline. ICD-10-ready releases are currently planned for availability at the end of 2011, well before the mandated compliance deadline. In addition, the 5-I Compliance Accelerator Program includes assessment services, migration support packages, business impact consulting, readiness roadmaps, transaction maps and supplemental resources to support system testing and implementation.
"We designed our 5-I program to help health plans achieve a successful and timely transition of their business processes and systems," said Steve Sabino, president of DST Health Solutions. "Beyond compliance, the 5-I program will help modernize key business processes, streamline operations and improve member satisfaction."
While some observers have questioned the healthcare industry’s readiness for this transition, it will also provide benefits, according to a May 18 FAQ published by CMS (http://questions.cms.hhs.gov/app/answers/detail/a_id/10027/kw/icd-10). ICD-10 will help health plans measure the quality, safety and efficacy of care; improve clinical, financial and administrative performance; and prevent and detect fraud and abuse, according to CMS.
"ConnectiCare will leverage 5010 and ICD-10 as opportunities for improvement over time," said Queen, who is also president of the board of DST Health Solutions’ Healthcare User’s Group (HUG). "ICD-10 does afford you the opportunity to become much more granular in how you design your business rules. It sets the stage for operational improvement and greater efficiency."
Source: DST Health Solutions LLC