Icd 10 implementation and business final slideshare

ICD-10 The Different Dimensions of Business Continuity Planning Presented by Mike Arrigo Managing Partner, No World Borders [email_address] July 21, 2011 WEDI Implementation Forum Advancing Down the Implementation Highway: Merging into 5010 Compliance, Shifting into ICD-10 http://www.noworldborders.com

More About Us http://www. noworldborders.com ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],http://www.noworldborders.com

ICD-10 BCP Topics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],http://www.noworldborders.com http://www. noworldborders.com

Unique Challenge of ICD-10 Three Constraints, Single Compliance Date Compliance Iteration & Innovation Vs. http://www.noworldborders.com

Five Principles of BCP http://www.noworldborders.com Business Impact Analysis Plan Development & Execution BCP LIFE CYCLE Test Plan Maintenance Plan Business Impact Analysis Risk Assessment Strategy Selection Plan Development & Execution

Business Continuity Planning for ICD-10 For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com Business Impact Analysis Plan Development & Execution ICD-10 BCP LIFE CYCLE ICD-10 Testing Post Live 10/1/2013 Support High Level Review, Gap Analysis ICD-10 Risk Assessment ICD-10 Business Impact Assessment ICD-10 Business Roadmap & Strategy ICD-10 Implementation Plan

Risk Mitigation ,[object Object],[object Object],[object Object],http://www.noworldborders.com http://www. noworldborders.com

The 5 to 6 Risk Areas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],http://www.noworldborders.com

ICD-10 Key Risks (page 1 of 3) Excerpts from 25 Risk Assessment Areas http://www.noworldborders.com Risk Risk Trigger Event Remediation / Mitigation HealthCo staff are not trained in ICD-10 impacts Training evaluation shows lack of knowledge (by 12/31/2011). Retrain as necessary Providers are not ready to submit ICD-10 codes Provider assessments and external testing show lack of provider preparedness. ,[object Object],[object Object],Vendor readiness / capabilities don’t meet SLAs Vendors do not deliver ICD-10 ready products by agreed upon date or do not provide the appropriate functionality. ,[object Object],[object Object],[object Object],[object Object]

ICD-10 Key Risks (page 2 of 3) Excerpts from f 25 Risk Assessment Areas For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com Risk Risk Trigger Event Remediation / Mitigation Payor financial risk – payments are significantly higher than anticipated Benefit payments for post Oct. 1 2013 services from Oct. 1 – Dec. 31, 2013 significantly higher than anticipated and impact HealthCo ability to pay. ,[object Object],[object Object],[object Object],[object Object],Provider financial risk – reimbursements are significantly lower than anticipated Benefit payments for post Oct. 1 2013 services from Oct. 1 – Dec. 31, 2013 significantly lower than anticipated and impact provider’s ability to operate as a business. ,[object Object],[object Object],[object Object],[object Object]

ICD-10 Key Risks (page 3 of 3) Excerpts from 25 Risk Assessment Areas For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com Risk Risk Trigger Event Remediation / Mitigation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Mitigate Vendor Impacts ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],http://www.noworldborders.com

Example: Project Dashboard Risk: ICD-10 Vendor Impacts T OCT 837 JAN 835 APR 834 NOV 999 FEB 270/271 MAY 278 TESTING NOV TA1 MAR 276/277 JUN 820 DEC 277CA Qtr 4 Qtr 2 Qtr 1 Qtr 4 Qtr 3 Qtr 2 Qtr 4 Qtr 3 Qtr 2 Qtr 1 Qtr 1 Qtr 3 Analysis -> ICD-10 Implementation -> Testing -> Go-Live Qtr 3 HealthCo provider lookup System Upgrades Prod 01/2012 4010 -> 5010 Migration Vendor A Vendor B Vendor C Vendor D prod 1 Vendor D, prod 2 Veendor D, prod 3 Vendor X, RFP Vendor E Vendor Y(RFP?) Vendor F Vendor G For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com

Example of Post October 1, 2013 Issue ICD-10 Updates ,[object Object],[object Object],For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com

Example of ROI Items (page 1 of 2) Real World Examples For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com Opportunity Benefit or Recommendation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ROI Items Identified (page 1 of 2) Real World Examples For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com Opportunity Benefit or Recommendation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],http://www.noworldborders.com

Mapping Observed Changes For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com Before Assessment During Assessment Remediation Plan thru October 1, 2013 ,[object Object],[object Object],[object Object],[object Object],[object Object],Ensure regular project management, governance, and requirements development activities are initiated immediately. These activities must be reviewed monthly and quarterly, with regular management oversight. Failure to start these activities will result in regression to where the organization was in August 2010. Training plans as recommended should be prioritized by functional area. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Training as a Risk Mitigation Strategy Example of Business Areas to Train ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com

ICD-10 Example Impact Assessment Functional Areas with the Most Risk For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com

Risk Mitigation: Clearly Identify Roles for Payor, Provider Work Teams for ICD-10 Risky thinking: “I need a good ICD-10 project manager….” Comment: “Yes, but there are other organizational competencies needed…” See http://slidesha.re/icd10orgstrat For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com

Provider Specific Factors for ICD-10 (Excerpt from Assessment) For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com

ICD-10 and Documentation Provide audit trail of assumptions Mitigate punitive regulatory impacts ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],http://www.noworldborders.com

What’s next? http://www.noworldborders.com

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],For a complete slide presentation, please contact No World Borders [email_address] http://www.noworldborders.com

Bottom Line ,[object Object],[object Object],[object Object],[object Object],http://www.noworldborders.com

Mike Arrigo Managing Partner, No World Borders [email_address] 949-335-5580 x1001 Recorded webinar on BCP and ICD-10 http://www. noworldborders.com http://www.noworldborders.com

Icd 10 implementation and business final slideshare

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Icd 10 implementation and business final slideshare