Companies and Solutions Providers See Challenges in ICD-10 Transition

As the year of 2010 comes to an end, healthcare outsourcing solutions providers have been racing against time to catch up on the requirements to achieve ICD-10 compliance for medical billing outsourcing. But even if the transition for ICD-10 would still be a couple of years from now, healthcare companies, medical billing companies and healthcare insurance providers included, are already seeking the assistance of outsourcing solutions providers.

But despite the pressure on healthcare companies to pursue their ICD-10 transition, healthcare institutions such as hospitals see this as expensive and quite difficult. The replacement of the present systems being used would be too costly, having an average of $2 million and $5 million in expenses to upgrade and replace them. According to the American Hospital Association, the companies are still in their early stages of upgrading their processes to ICD-10 despite the fast approaching deadline in October 2013. This can be quite understood as the present ICD-9 codes have been deeply embedded in today’s processes, given that it has been around for a long time. Survey results by the Medical Group Management Association show that majority of the companies are claiming that they are still not prepared to take on the transition.

However, it is not only the medical institutions that see the challenges being posed by the transition from ICD-9 to ICD-10 because even the solutions providers see that the transition poses complex processes. It is those who provide healthcare IT solutions to medical institutions, such as hospitals and insurance companies, are the ones being greatly affected by this. The wide implementation of electronic health records (EHRs) have been quite helpful, though tedious, for some and to ensure the implementation of a systems upgrade for the ICD-10 transition would need additional efforts from them. For outsourcing solutions providers and healthcare providers alike, Rick Schooler, the VP and CIO of Orlando Health, pointed out that the transition would require dedicated project management support, as well as the support and involvement of people throughout the organization.

A few weeks into the month of June this year, despite the challenges being raised for the transition of ICD-10, Blue Cross and Blue Shield Association and Infosys (NASDAQ:INFY) issued a press release announcing that the latter has been selected by the former, among the many other solutions provider who have been competing to seal the deal, to provide assistance in their ICD-10 transition. The product suite of Infosys named iTransform would address the various needs of the 39 Blue Cross and Blue Shield healthcare plans being offered across the United States; such capabilities of the Infosys product suite would be immediately available for Blue Cross and Blue Shield to incorporate into their business.

The healthcare industry and the outsourcing industry still have more than two years to prepare themselves for the ICD-10 transition. It would be best to start planning on they would take on the transition, even if there are time and budget constraints, because two years may sound a long time from now, but acting today may prove better preparation and better ICD-10 transition.

Written by Jeff De Jesus

Jeff De Jesus

With his exposure to the outsourcing industry since 2003, Jeff was able to share and implement his leadership insights with respect to managing business process accounts, particularly in the healthcare department. Jeff has also taken part in assessing the fundamentals of the company’s operational processes, utilizing his experience as an Operations Manager across different verticals, identifying and executing methods that can improve the quality of workflow in the company. Jeff’s experience is not only limited to the Healthcare solutions as his capability in handling Customer Support is also mirrored in the successes that the company has achieved.

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  1. Shim Code says

    This is a misleading post.

    It is simply not true that Infosys will “provide assistance in their (BCBSA’s) ICD-10 transition.”

    What actually happened is that Infosys was selected as a “preferred vendor” by the association and is recommended to BCBS licensees – as have a number of other vendors. BCBS licensees are free to choose whomever they want – and they often do. For instance, HLI was approved by BCBSA but I don’t know of many/any licensees who signed up with HLI.

    How many of the 39 licensees are actually using the iTransform product?

    These press releases that companies like Infosys and HLI put out are very misleading and imply that their products are used by all BCBS licensees. They are not!

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