Health insurance business is undergoing dramatic changes to address healthcare reforms and regulatory mandates to emerge as more matured, agile and standardized industry. The payers are increasingly considering business transformation and new technology adoption to improve health outcome, sustain business growth and remain competitive, with the following initiatives:

Hospitals today are under severe pressure to improve the quality of care and reduce medical errors while ensuring compliance with stiff state and federal laws. With tight IT budgets and limited skilled resource pool, it is increasingly becoming a challenge to balance these requirements.

With stringent demands for fast turnaround time for results from clinicians and clients for quality patient care, high clerical overheads (paper work) and transcription errors and management demands for timely information on workload and statistical reports. Laboratory Information Systems (LIS) are assuming prime importance. Often playing the part of an integrated informatics system, LIS integrate many disparate applications. The use of an LIS plays a major role in the clinical IT spectrum of systems and assumes prime importance to the overall care given to patients.

The healthcare industry operates on a platform of critical resources drawn across a complex network that consists of distributors and suppliers. Healthcare distributors need to incorporate a ready edge to meet the constant demands of various inter-connected departments and this is where Wipro comes in to help streamline your healthcare distribution process.

The healthcare industry today is a very complicated industry. Its dependence on IT infrastructure is aimed to deliver better Healthcare services to an increasingly product conscious consumer. The problems faced are enormous, from regulatory compliances to state and federal mandates, and the need to offer customized Healthcare services. Besides, accuracy is a pre-requisite and any minor error can lead to severe consequences leading to negative brand value as well as legal complicacies. The need of the hour is to access a sophisticated and efficient system to address these challenges across all sectors in this industry.

The Department of Health and Human Services (HHS) requires all covered entities to adopt and comply with the ASC X12 TR3 version 5010 as a modification to the current HIPAA transaction standards by Jan 1, 2012.

The first major milestone in this conversion – achieving Level 1 compliance, requires entities to begin testing with external trading partners by January 1, 2011.

The U.S. Department of Health and Human Services (HHS) released the final rule in Jan 2009 that requires the adoption of ICD-10 code sets by healthcare organizations with a compliance date of Oct 1, 2013. ICD-10 consists of ICD-10-CM which is a U.S. clinical modification to the WHO ICD-10 code set to report diagnoses and ICD-10-PCS which is a U.S. creation to report inpatient hospital procedures. ICD-10-CM replaces the current ICD-9 Vol I and II code sets and ICD-10-PCS replaces the current ICD-9 Vol III code set effective the compliance date.