Given that there is one more year to go, the majority of the healthcare organizations should be prepared and ready to accept ICD-10 codes. Payers face a major challenge in working with providers and various clearinghouses to make sure they can accept the codes and have done adequate testing well in advance to avoid any last minute glitches. Most payer organizations need to prepare for the testing phase of ICD-10, which is rather cumbersome and painful considering the sheer number of partners involved.
There are five key areas of testing that are often neglected and are very critical at this stage of the ICD-10 migration. The reality check for ICD-10 readiness is more qualitative than quantitative, compared to other implementations. Being ready for ICD-10 does not mean just running through a high volume of claims and validating the results. It starts with the selection of test scenarios, data and validation. Below are five key areas of testing that healthcare payers need to consider:
- Integration Testing (Internal): This stage involves merging all individual components of ICD-10 impacted modules and executing a test to accomplish the flow of ICD-10 data. The key focus during this phase should be to identify any additional components that have to be coded for ICD-10, optimize work flow with the addition or removal of any new steps for review and approval, and validate the test region to make sure all the required components have been integrated.
- End-to-End Testing (Internal): During this phase, all the additional non-impacted modules and systems are moved to the test region. The key focus for organizations should be to validate that the entire system is functioning efficiently with no major issues, validate all internal and external reports and engage business users in validating the ICD-10 data outputs. Additionally, the objective should be to establish a solid test region that mimics production in all aspects and validates that ICD-10 implementation has been completed and the organization is now ready to engage with external entities.
