Advancing Along the Implementation Highway: The Road Map to Success
5010, ICD-10 Implementation Forum

July 28-29, 2009

Fairfax Marriott at Fair Oaks

Fairfax, VA

Agenda

Tuesday, July 28, 2009

8:00-9:00 AM Registration, Continental Breakfast

9:00 -9:15 AM Welcome, Introductory Comments

Laurie Darst, WEDI Education Co-chair, WEDI Board Member; Mayo Clinic

*WelcomeandintroductionofSMEandscribes

*Previous WEDI 5010 discussion from April Conference

*SNIP 5010 SWG and Sub-Groups

* Forum Purpose - craft solutions andidentify best practices

* Review agenda - rules of order

9:15-10:30 AM NPI and Claim-Related Issues

John Bock, WEDI SNIP 5010-837 Co Chair; President, eEmergence, Inc.

Gail Kocher, WEDI SNIP Steering Committee Co Chair, WEDI Board, X12 Rep; Director, Health Information Technology, Blue Cross Blue Shield Association

*NPI and 837 Requirements Overview

*NPI Enumeration and 837 standardization requirement

* Billing and Pay to Provider requirements

* Service Facility and Billing Provider NPI reporting requirements

10:30 - 10:45 AM Break

10:45 - 12:30 PM NPI andClaim-Related Issues

* Continue discussion onNPI and 837 requirements

12:30 - 1:30 Lunch

1:30 - 3:00 PM Patient/Subscriber reporting requirements

3:00- 3:15 PM Break

3:15 - 4:45 PM Other transaction changes

*Claim (837)- Standardized anesthesia reporting, compound drug reporting and others

*Remit (835)CLP02, Remark Code usage, balancing issues, recoupment process, others

* Eligibility (270/271), Additional service type codes, alternate search logic, reporting of patient specific identification

4:45-5:00PM Wrap up

5:15- 6:10 PM Informercial—Foresight Corporation Presents:

Unique Services & Solutions for Successful HIPAA 5010 Migration

Based on the experience and understanding from guiding numerous healthcare organizations through their 4010A1 implementations, we invite you to learn about Foresight’s unique services and solutions to facilitate your HIPAA 5010 migration. Foresight’s step-by-step plan for achieving HIPAA 5010 compliance includes:

§  Level 1 Solutions – Preparing your internal systems and proving your readiness to test with partners - including DISAcert, the expert HIPAA 5010 certification service

§  Level 2 Solutions – Partner testing solutions including scenario-driven testing, partner self-testing portal, and mass-parallel testing. And Foresight’s solutions fully support the Dual Production period.

§  Beyond 5010: EDI Modernization – Steps you take now will position you for future success through an integrated platform for transaction automation, validation and visibility, concepts pioneered by Foresight.

Whether you’re a Payer, Provider, Clearinghouse or Vendor, you’ll find new ways to speed and simplify HIPAA 5010 compliance for you and your partners.

Speakers:

Debra Strickland, Senior Solutions Architect, Foresight Corporation

Cookie Mockensturm, Corporate Accounts Manager

Wednesday, July 29, 2009

7:30 – 8:00 AM Continental Breakfast

8:00 - 8:15AM Recap of Tuesday's Discussion

Laurie Darst, WEDI Education Co-chair, WEDI Board Member, Mayo Clinic

*Recap of previous day’s activity

*Today’s agenda

8:15-10:15 AM Medicare’s Approach to 5010

Chris Stahlecker, Director, DMBP, Centers for Medicare and Medicaid Services

*Discussion on impact of Medicare changing their front end processing

10:15-10:30 AM Break

10:30 - 12:00 PM Implementation Issues and Other Considerations

*Impact of State Medicaid implementations on the industry

*Influencing Upper management to make 5010 a priority now

*Education opportunities

*Test Scenarios

*Assess need for readiness tracking tools

12:00 PM Lunch

Everyone is invited

12:00 – 1:00 PM Registration, Lunch

1:00– 1:30 PM Welcome, Introductory Comments

Jim Daley, WEDI SNIP ICD-10 Co Chair, WEDI Board; BCBS SC

·  Welcome and introduction of SME’s and scribes

·  Previous WEDI ICD-10 activity

·  SNIP ICD-10 SWG and sub groups

·  Forum purpose – craft solutions, identify best practices, determine needs for additional assistance.

·  Forum agenda

·  Rules of order

·  Review listed topics, survey for additional topics

1:30 – 2:45 PM Timeline

Stanley Nachimson, NCHICA WEDI Timeline Initiative, Project Director; SNIP ICD-10 Timeline SWG Co Chair; Nachimson Associates, LLC

·  Timeline overview presentation

·  Where are you now?

·  Where should you be now, in 6 months, etc?

·  How to get started or back on track

·  Interaction with trading partners and vendors

·  Early Adopter perspectives on timeline

2:45 – 3:00 PM Break

3:00 – 4:30 PM Project Team Formation and Governance

Andrea Danes, WEDI SNIP Transactions Co Chair, WEDI SNIP ICD-10 Education SWG Co Chair; CSG Government Solutions

·  Strategic Planning

o  Prioritization and interaction with other projects, including 5010

o  Budget planning and monitoring

·  Governance

o  Executive Support

o  Steering Committee

o  Core Management Team

o  Subject Matter Experts

·  Project Management Principles

o  Communication plans

o  Training and Outreach (internal and external)

o  Risk Identification and Management Plan

o  Issue Identification and Management Plan

o  Quality Management Plan

o  Independent Verification and Validation Plan

4:30 -5:00 PM Wrap Up

5:15 – 6:10 PM Informercial—Ingenix, Inc.

5010 and ICD-10 Mandates:

More than Compliance . . . Mitigate Risks and Maximize Rewards

Join us for a compelling, interactive discussion on the 5010 and ICD-10 mandates and how to jointly leverage these important industry standards for operational efficiency.

We’ll share our perspective, survey results, ROI examples, and how to minimize disruption and optimize deployment – so your organization can effectively implement the standards, and actively contribute to our nation’s health care reform.

All infomercial attendees will be eligible to participate in the Netbook drawing. You must be present to win.

Presented by:

Tim Michaels, Vice President, Ingenix Consulting

Peter Firehammer, Vice President, Ingenix Connectivity Solutions

Thursday, July 30, 2009

7:30 – 8:00 AM Registration, Continental breakfast

8:00 – 8:05 AM Recap of Wednesday’s Discussion

Jim Daley, WEDI SNIP ICD-10 Co Chair, WEDI Board; BCBS SC

·  Recap of prior day activity

·  Current day agenda

8:05 – 9:15 AM Impact Assessment

Dave McCord, TM Floyd & Company

·  Assessment process

·  What questions should you be asking your vendor?

·  Results to date

·  Observations/surprises

·  Best practices

9:15 – 10:15 AM Crosswalks

Jim Daley, WEDI SNIP ICD-10 Co Chair, WEDI Board; BCBS NC

·  General background presentation

·  Applicability

·  Location/use

·  Design considerations

·  Business implications

·  Long term impact

10:15 – 10:30 Break

10:30 – 12:00 PM Testing and transition

Dave McCord, TM Floyd & Company

·  Internal Testing vs. External Testing

·  Need for “end-to-end” testing

·  How to accomplish

·  Potential issues

·  Scheduling policy changes

·  Conversion process/runoff

·  Pre & Post Transition Training

·  Transition Documentation

·  How/when to stop using a crosswalk

12:00 – 1:00 PM Lunch

1:00 – 2:15 PM Clinical considerations

Joseph Nichols, MD, ViPS, Inc.

·  Definitions and terminology

·  Translation between 9&10

·  Capturing the right data for coding at the point of service

·  Coding from documentation

·  Analysis based on ICD9 & 10

·  The definition of risk and severity

·  Measuring provider performance

·  Rules and Guidelines

·  Patient History

2:15 – 2:30 PM Break

2:30 – 3:30 PM Other

Jim Daley, WEDI SNIP ICD-10 Co Chair, WEDI Board; BCBS NC

·  Workers comp, life products

·  Public health

·  Items raised at forum

3:30 – 4:00 PM Recap and next steps

Jim Daley, WEDI SNIP ICD-10 Co Chair, WEDI Board; BCBS NC

4:00 PM Adjourn