Handle every aspect of ICD-10 assessment, remediation, implementation and educationAltegra Health offers a comprehensive ICD-10 service offering to assist healthcare providers in every facet of ICD-10 implementation. Our organization is uniquely qualified not only to provide guidance on ICD-10 and HIPAA 5010, but also to evaluate readiness for the changes, to recommend solutions, and to assist with the implementation of those solutions. Our consulting organization staff members have practical experience in information technology, clinical care, compliance, revenue cycle, clinical documentation improvement, and coding.
Is Your Organization Ready?Download the ICD-10 Checklist to find out.
ICD-10 Solution Features
As part of the transition to ICD-10, health plans are considering how provider processes and incomplete preparation impact health plan costs, revenues, and ultimate financial performance. Coder training takes time, decreasing productivity and claim processing volume. System and payer contract adaptations, clinical documentation shortfalls and coding errors will increase claim edits and denials, decreasing risk scores and increasing the number of claims incurred but not paid (IBNP).
Education & Training
- Organization-Wide ICD-10 Awareness Training
- Medical Staff ICD-10 Awareness Training
- Specialty-Specific Clinical Documentation Training
- In-house Coder ICD-10-CM/PCS Training
- Department-Specific Customized Staff Training
- Outsource Coding Services
- Staff Augmentation Services
- Clinical Documentation and Physician Coding Evaluation
- Clinical Documentation Program Review
- Coder and CDI Query Evaluation
- Health Information Management Coding Workflow and Capacity Evaluation
- Business Impact Summary and Gap Analysis
- Revenue Cycle Impact Financial Modeling and Budgets
- Evaluation of Payer Contracts
- ICD-10 Preparedness Assessment and Gap Analysis
- Reimbursement Impact Analysis and Claims Evaluation
- Education and Training Plan
- Change Management Plan
- Implementation Budget Estimates
- Remediation Steps and Implementation Plan
- Enterprise Roadmap & Budget (with Risks & Opportunities)
- Contingency Plan Development
- System and Application Impact Summary (with Reports and Dashboards)
- HIPAA 5010 Gap Analysis
- Conversion Requirements
- Enterprise Crosswalk Requirements
- Vendor Readiness and Timelines
- Test Requirements for Remediation
- Code Conversion (Source Code and Database Tables)
- Regression and Remediation Test Scripts; Payer Testing Scripts, and Test Data
ICD-10 Safety NetAs part of the transition to ICD-10, health plans are considering how provider processes and incomplete preparation impact health plan costs, revenues, and ultimate financial performance. Coder training takes time, decreasing productivity and claim processing volume. System and payer contract adaptations, clinical documentation shortfalls and coding errors will increase claim edits and denials, decreasing risk scores and increasing the number of claims incurred but not paid (IBNP).
Safety Net Features
We at Altegra Health are continuing our efforts to help our partners prepare for ICD-10. Our ICD-10 Project Team has established a comprehensive implementation plan to identify and address all the components impacted and related to this conversion. Please contact us to learn more about what Altegra Health can do for you.
- Education - Provider and health plan education for ICD-10 and risk adjustment. This robust and specialized education can be delivered to providers and their staff through self-paced learning modules or in-person through customized sessions.
- Staffing Solutions - Altegra Health has a pool of fully trained ICD-9 and ICD-10 coders to temporarily assist on-site in provider or health plan offices to keep productivity flowing during ICD-10 training or to address claim edit/denial bottlenecks post-transition.
- Coding Documentation Support & Audits - Full service retrospective coding and validation audits ranging from detailed compliance, to all code ICD-10, or just risk adjustment code audits for targeted providers to assure adequate documentation. Altegra Health auditors are also familiar with all electronic medical record (EMR) systems and can review the flow and quality of documentation flowing through the EMR into health plan systems.
- Revenue Optimization - Deep technical and coding expertise provides the framework for technical system reviews between provider and health plan to identify revenue generating data losses. Additionally, an ICD-10 risk adjustment revenue impact analysis compares risk scores before and after the ICD-10 transition to identify potential revenues losses.
- Claims Based Solutions - Altegra Health coders and consultants can help prioritize and reduce the volume of claim edits, denials and resubmissions. Our consultants also provide payment integrity reviews to identify erroneous provider billing.