ICD-10, HIPAA 5010 Compliance
Meet Regulatory Compliance Mandates
Healthcare organizations continue to shift business and technology resources to comply with, participate in, and support external initiatives and mandates, including compliance with emerging standards HIPAA 5010 and ICD-10. An intelligent and flexible IT infrastructure that meets immediate compliance requirements – while also being able to scale, leverage and extend existing core IT assets as additional compliance initiatives are mandated – is the foundation for success.
TIBCO utilizes a rapid, code-neutralization strategy to implement ICD-10, which doesn't require massive code generation. And TIBCO's industry-leading EDI productivity tools can help you prepare for for each stage of HIPAA 5010 migration:
- Gap analysis identifies the differences between your custom 4010A business rules and the new 5010 standard
- Guideline management transforms your custom business rules into the 5010 standard
- Testing and migration ensures the readiness of your systems and trading partner community
- Production enforcement and analysis validates a submitter's files in production
TIBCO's framework provides a successful migration strategy that enables healthcare organizations to:
- Improve process efficiency: Increase provider participation in X12N 270/271 (eligibility for a health plan), reducing the number of erroneous or inappropriate claims
- Accelerate processing and reduce costs: Electronic submissions improve the speed and accuracy of claims resolution while leveraging existing infrastructure
- Rapid deployment: TIBCO's ICD-10 conversion strategy helps payers meet stringent timelines with the ability to handle new mandates in the future
