Emdeon Paper-to-EDI Conversion ICD-10 Frequently Asked Questions. Published Q3 2013

Transcription

1 Emdeon Paper-to-EDI Conversion ICD-10 Frequently Asked Questions Published Q3 2013

2 Preface This information is provided by Emdeon for education and awareness use only. Even though Emdeon believes that all the information in this document is correct as of the date of the publication of this version, Emdeon does not warrant the accuracy, completeness, or fitness for any particular purpose of this information. All use is at the reader s own risk. The information provided here is for reference use only and does not constitute the rendering of legal, financial, or other professional advice or recommendations by Emdeon Emdeon Business Services LLC, 3055 Lebanon Pike Suite 1000, Nashville, TN All Rights Reserved. Printed in the USA.

3 Contents Customer Communications... 4 Readiness & Planning... 4 ICD Code Utilization... 5 Cross-Walking Position... 6 Trading Partner Contingency Planning... 7 Customer Impact... 7 External Testing Approach... 9

4 Customer Communications Q: Who is the primary contact for discussing questions regarding Emdeon's ICD-10 remediation and implementation activities? A: Please contact your Emdeon Account Representative. Q: Who will be providing training communication and materials for ICD-10 related application changes? A: If required and requested by customers, Emdeon will deliver training for Emdeon Paper-to-EDI Conversion (P2E) changes for ICD-10 via a live or recorded WebEx session. The training will cover application changes, suggestions on testing ICD-10 migration changes and a question and answer period. Readiness & Planning Q: Do you have a statement of readiness for ICD-10? A: Emdeon is in active implementation to enable all three P2E lines of business (Professional, Institutional and Dental). Coding has been completed on all three LOBs and is being integrated into the Emdeon P2E solution with staggered target readiness dates throughout Q: Will your products be ready for the ICD-10 compliance date? A: Yes, our target readiness for all three P2E lines of business is by end of Q: What is the communication schedule for keeping customers informed of remediation milestone progress? A: Communication regarding ICD-10 remediation will be provided in the regular monthly client scorecards and client updates.

5 ICD Code Utilization Q: Will the product allow for coding in both ICD-9 and ICD-10 to accommodate both transactions with dates of service before October 1, 2014 and transactions with dates of service after October 1, 2014? A: Emdeon P2E will be able to extract, validate and send to the Emdeon Clearinghouse both ICD-9 and ICD-10 transactions with dates of service before and after the ICD-10 compliance date. The Emdeon Clearinghouse will implement ICD-10 on October 1, Early adoption of ICD-10 for providers and health plans will not be supported, and ICD-10 coded transactions will not be accepted in our production environments prior to October 1, Q: Will your products accommodate both the ICD-10-CM/PCS and ICD-9-CM code sets simultaneously in P2E dual use testing? A: Emdeon P2E software modifications for ICD-10 remediation include dual use capability. The software detects the version of code submitted and applies the appropriate qualifiers based on the detection. The software may be deployed in production any time before the ICD-10 compliance date. Q: Will the application(s) support dual use of the ICD-10-CM/PCS and ICD-9-CM code sets simultaneously after the October 1, 2014 implementation? How long do you anticipate dual use can be supported? Is this addressed in the contract? Is additional support needed in a dual use mode? A: Emdeon P2E software will support both ICD-9 and ICD-10 codes after the ICD- 10 compliance date. Q: How long will ICD-9 be supported and accepted for process/storage? A: Emdeon does not anticipate at this time the removal of ICD-9 logic from the Emdeon P2E applications. Future updates may remove the support, but this modification is not currently planned.

6 Q: What data validation changes are required to support ICD-10 related changes to the application? A: Diagnosis code validation has been modified to allow for either ICD-9 or ICD- 10 code format and content validation. Logic validating the length and format of the codes was modified. Q: How can the ICD-9-CM codes be disabled for dates of service after October 1, 2014, while remaining enabled for earlier dates of service. Also, how will ICD-9-CM legacy data be accommodated? A: If the client requires enforcement of code version usage, payer specific edits may be implemented according to the payer s specific usage requirements. Q: How do you plan to accommodate ICD-10 code sets into your application/solution/interface? A: The general changes required for ICD-10 compliance include adding additional ICD-10 table and diagnosis code validation, new diagnosis code format validation, expanded formats for diagnosis code data entry, detection logic to determine code version submission and new ICD-10 code qualifier addition and mapping to output. Cross-Walking Position Q: Will a mapping or cross-walk table be used between ICD-9 and ICD-10 code sets? A: No, Emdeon P2E software does not include ICD-9 to ICD-10 mapping or crosswalk. Q: Specify how the ICD-10-CM/PCS compatible application version can handle ICD-9- CM codes interfaced with other applications (for example, will ICD-9-CM codes be cross-walked to ICD-10-CM or ICD-10-PCS codes?). A: Emdeon P2E software does not provide cross-walking between ICD-9 and ICD- 10 codes.

7 Trading Partner Contingency Planning Q: What is your contingency plan if your application/solution/interface is not ready by the compliance date? A: Emdeon has allocated appropriate resources toward ICD-10 and remediation activities are currently underway. Emdeon has completed our analysis and design phase and we will remediate any identified gaps within our systems or applications to ensure Emdeon is ICD-10 ready. Emdeon s remediation is scheduled to conclude within 2013 well in advance of October 1, Customer Impact Q: Do your current Emdeon contracts cover your practice s ICD-10 related needs? A: Emdeon P2E clients using the standard P2E solution are covered for ICD-10 transition. P2E clients on legacy solutions are not covered for ICD-10 transition and must contract for ICD-10 transition or migrate to the standard P2E solution prior to ICD-10 mandated usage. Q: What steps do your customers need to take to continue utilizing your ICD-10 upgraded application? A: Emdeon P2E clients may elect to participate in P2E ICD-10 testing for each of their P2E lines of business. Each client may migrate each P2E LOB to the ICD- 10 ready solution prior to ICD-10 mandated use. If clients elect to not participate in testing they will be migrated through Emdeon internal testing prior to the mandated use date. Information and target dates for each client s migration will be provided by your account representative. Q: Are there any new hardware requirements associated with ICD-10-related software changes? A: Emdeon s P2E ICD-10 solution does not require hardware modifications to support ICD-10 related software changes.

8 Q: Do you anticipate any pricing changes (financial or contractual impact)? Will modifications and upgrades be covered by existing contracts? A: Emdeon P2E clients utilizing the standard P2E solution (excluding custom or legacy applications) will incur no cost for standard ICD-10 migration. However, any payer specific logic for custom ICD-10 handling may incur charges. Q: Do interface assessment and modifications require an additional cost? If so, what is the cost structure, and when is the cost incurred? A: Emdeon P2E clients utilizing the standard P2E solution (excluding custom or legacy applications) will incur no incremental costs associated with Emdeon s ICD-10 readiness efforts. However, incremental costs could result from optional services (non-standard) such as Contingency Planning, Cross-walks and Data. Q: Will customer support and training be provided for any new ICD-10-related functionality, and is there a charge? A: Emdeon will provide at no charge and if requested a general WebEx to instruct clients on the ICD-10 updated software integration. Client specific assistance or training must be contracted as stated above. Q: Must a contract addendum be signed before work on the system modifications? If so, what are the terms of the contract addendum? A: No contract addendum is required for work to make Emdeon products ICD-10 ready. Contract addenda will be required for optional services (non-standard). Q: Will the ICD-10 upgrade to the application require a contract modification? A: Contract modifications are not required to make Emdeon products ICD-10 ready. Contract addenda will be required for optional services (non-standard).

9 External Testing Approach Q: Will Emdeon P2E install products well before the October 1, 2014 deadline, so you can begin testing them in 2013? A: Yes, once testing is completed the solution may be placed into production at any time prior to the ICD-10 compliance date. Q: What is Emdeon P2E s timeline for ICD-10 transition? A: Each P2E Line of Business has a specific client testing readiness date. Once testing is completed the solution may be placed into production at any time prior to the ICD-10 mandated usage date. Each line of business date is listed below: i. P2E Dental transition is expected to be ready for testing August ii. P2E Professional transition including CMS /12 is expected to be ready for testing October iii. P2E Institutional transition is expected to be ready for testing December Q: Has Emdeon P2E scheduled with you to test your system with your trading partners? A: Each Emdeon P2E client may contact their account manager to schedule testing. Although it is not imperative that each client perform ICD-10 P2E testing, it is recommended that the client participates in ICD-10 P2E testing. Emdeon is a leading provider of revenue and payment cycle management and clinical information exchange solutions, connecting payers, providers, and patients in the U.S. Healthcare system. Emdeon s product and service offerings integrate and automate key business and administrative functions of its payer and provider customers throughout the patient encounter. Through the use of Emdeon s comprehensive suite of products and services, which are designed to easily integrate with existing technology infrastructures, customers are able to improve efficiency, reduce costs, increase cash flow and more efficiently manage the complex revenue and payment cycle and clinical information exchange processes. For more information, visit Emdeon Business Services LLC. All rights reserved Lebanon Pike, Suite 1000 Nashville, TN EMDEON.6 ( )