Health insurer WellPoint and software vendor Cerner Corp. have aligned to conduct a pilot program to get ready for end-to-end testing of transactions populated with ICD-10 codes.
Under the arrangement, participating provider clients of Cerner will select claims that have been submitted to and paid by WellPoint after being coded in ICD-9, recode in ICD-10, send the claims to WellPoint via clearinghouses for adjudication and post the 835 remittance advice. Cerner and WellPoint then will assess differences in successful completion of the claims/payment processes, such as payment and denial rates, which will help the organizations determine if they are on track with their ICD-10 compliance work.
Cerner systems being used in the pilot include the Financial Hub and Patient Accounting software suites, and all systems involved in coding, billing or interfacing to clearinghouses. One area of focus in the pilot will be the workflow of systems for physician documentation, medical coding, billing and interfacing to offset predicted reductions in coding productivity, says Rick Heise, vice president of revenue cycle.
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