ICD 10 Compliance and Quality Assurance

The ICD 10 Compliance deadline is drawing to a close and Healthcare organizations need to aggressively move from implementation to the testing phase. The move to ICD 10-based diagnosis and procedure codes from ICD 9 is a paradigm shift on how the services are codified and reimbursed. It touches virtually every component of financial, administrative and clinical processes, with a wide ranging business impact on business process, people and technology for both Providers and Payors.

How Wipro Helps

Wipro has supported Healthcare organizations throughout the ICD transition journey across different phases.

Our proven ICD-10 suite of solution and services include:

  • Business process and impact assessment
  • IT systems remediation
  • End-to-end testing and on-going compliance
  • ICD 10 solution accelerators
  • ICD 10 advanced analytics to reduce revenue leakage, ascertaining fraud, waste and abuse

Leveraging our ICD 10 framework and methodology, we not only enable compliance post initial impact assessment, testing and remediation but also ensure on-going compliance. This results in improved reporting, governance and helps deliver improved customer satisfaction, loyalty and drives growth.

Given the current industry emphasis on robust ICD 10 end-to-end testing, we have customized our solution and services that enable ICD 10 testing and leveraging of the below components:

  • Test Data Management
  • Risk-Based Testing
  • Reimbursement Neutrality Testing
  • WipDVA (Data Migration Validation Acceleration Solution)
  • Wipro Enterprise Data Obfuscation Solution
  • Regression Test Accelerator
  • Automated conversion of ICD 9 to ICD 10 based 837 files
  • Smart search for ICD 9 & ICD 10 codes and customization capabilities
  • Automated financial neutrality and CMS reimbursement mapping based testing
  • Dual processing ICD support

Our advanced analytics solution and services can be leveraged for an on-going ICD 10 compliance monitoring and reporting at operational and business process levels. These can be clinical documentation integrity, revenue cycle, patient access services by Providers and claims/customer operations, Benefit Contracts Management and Medical Management reviews by Payors.

We have worked with leading Healthcare organizations, including health plans, health systems and health and human services agencies on ICD 10 initiatives.