1. Hello, I’m from HCL! We work behind the scenes, helping our customers to shift paradigms and start revolutions.
We use digital engineering to build superhuman capabilities. We make sure that the rate of progress far exceeds
the price. And right now, 90,000 of us bright sparks are busy developing solutions for 500 customers in 31 countries
across the world. How can I help you?
www.hcltech.com
For more information contact healthcare@hcl.com
Case Study 2
Leading Healthcare
Commercial Payer
Client
Leading Healthcare company providing network based healthcare
benefits and services to more than 25 million customers.
Business Problem
• Comply with ICD-10 regulatory requirement
• Managing complex mapping scenarios with minimal impact
• Identifying impacts to various medical policies
• Maintaining clinical equivalence and payment neutrality for
minimal ICD-10 transition impact
• Maintaining Benefit neutrality and updating various business
artifacts
• Getting the right case mix of data for testing
• Ensuring accurate comparison between ICD 9 and ICD 10
claims
Solution
• HCL proposed its proprietary ICD-10 tool suite comprising
of consulting frameworks, mapping tool, testing frameworks
and testing tool. The highlights of solution provided by HCL
include
• Experienced Medical coders and clinicians to perform
mapping of complex scenarios.
• Creation of custom maps to achieve clinical equivalence.
• Data analytical services using payer’s historical claim data
• Test Deck and Test Run management using proprietary tool
Value Delivered
• Provided the client with a clear understanding of ICD-10 code
usage and complexity associated in the key medical policies
for different functional areas
• Created a repeatable process for code mapping and
governance
• Consultation services for mapping
• Consulting services for Neutrality - provider reimbursements,
medical policy management and benefits management
HCL’s Strength
• Strong Domain knowledge in healthcare space
• Already offering ICD-10 consulting services to large number
of Payers
• Dedicated ICD COE with 500+ SME’s
• Tools and Accelerators
• Testing, Technology COEs
ICD Transformation
for a Leading
Healthcare
Commercial Payer