ICD-10 has now been implemented, but the work is still ongoing. Now, you must ensure that your system is working as it should, and keeping up with the initial changes that the conversion to ICD-10 has brought and changes that will continue to occur during the life cycle of ICD-10.

Since the implementation, how has your organization been impacted?

Are you seeing discrepancies in the amount that you expected to receive for reimbursement for services you performed? Whether you are receiving too much or too little reimbursement, this inconsistency can be rectified with software testing.

How are you handling the new Diagnosis-Related Groups (DRGs) that result from the increased number of codes in ICD-10? With an abundance of new diagnosis and procedure codes that are more specific, the number of DRGs will expand as well. We can help you make sure that you receive the correct reimbursement based on the services you provide and the codes you submit.

In order for ICD-10 to work as it should, it must be confirmed that systems are up-to-date and handling the data load effectively. We can put your system through testing to make sure it can handle not only the normal expected volume, but also any unexpected increases in volume.

        We offer consulting services
        and automated solutions to help with:

  • o Implementation planning and governance
  • o Project plan development
  • o Organizational impact mitigation
  • o Development of crosswalk methodologies
  • o Automated ICD-10 code conversion
  • o Identifying the maximum-impact ICD-10 codes:
    • o Highest potential revenue impact, most error-prone
  • o Testing for ICD-10 compliance internally and with trading partners
  • o Testing for ICD-10 compliance and revenue neutrality, which is
       especially difficult for:
    • o Many-to-many code mappings
    • o Diagnosis Related Groups
    • o Patient benefits, including deductibles, co-pays, coinsurance,
         and other accumulations
  • o Revising and implementing medical policies and procedures

The Ballard Group has fourteen years of experience in successfully planning, managing, and executing comprehensive testing for large, complex projects. We understand healthcare organizations, having worked over the years with such organizations as Landmark Healthcare, California Department of Health Care Services, California Department of Public Health, Vision Service Plan, and California Department of Mental Health.

With the Ballard Group's assistance, you can be assured that your systems are equipped to handle the changes brought on by the transition to ICD-10, and adapt effectively as more updates occur.