ICD-10 & HIPAA Compliance at VIPS

Meeting the challenges of the ICD-10 conversion is a job that requires a collaborative effort among payers, providers, vendors and partners. As a leading healthcare IT vendor and business partner to the Centers for Medicare and Medicaid Services (CMS) and the private healthcare sector, ViPS understands that ICD-10 regulations will affect our solutions, products, procedures and processes for handling healthcare data. Working collaboratively with our customers and partners, we are executing a comprehensive ICD-10 strategy that will help ensure ICD-10 compliance readiness of our company and products, where applications are in accordance with the required October 1, 2013 compliance date.

Through close monitoring of ICD-10 compliance developments and involvement in organizations like American National Standards Institute x12 (ANSI x12), National Council for Prescription Drug Programs (NCPDP), Workgroup for Electronic Data Interchange (WEDI), and other relevant organizations, we understand the ICD-10 conversion complexities and how these issues translate to requirements for ourselves and our customers. Our involvement with the Centers for Medicare and Medicaid Services (CMS) in support of the Medicare program has also positioned us on the forefront regarding ICD-10 compliance standards.

 ICD-10 Readiness Services
 NAV-10 Code Translation Suite

For information regarding ICD-10's impact on specific ViPS products and ICD-10 compliance, just call 1-888-545-8477, ext. 8010.

ICD-10 Readiness

Our products and services depend on quality healthcare data. As such, successful transition to ICD-10 for all of our products and services is critical to our sustained success. We have developed a plan to achieve ICD-10 compliance in all our products.

Additionally, ViPS is committed to implementing our ICD-10 plan to ensure that our products are ready for testing in advance of the October 1, 2013 compliance date.

We understand that any successful endeavor is based on a thorough knowledge and understanding of the subject matter and industry environment. To that end, in early 2008, we dedicated a team of professional healthcare information technology (IT) subject matter experts to become knowledgeable and well-versed in ICD-10. To help ensure that their ICD-10 knowledge is current, the team participates in industry conferences related to ICD-10, such as WEDI and American Health Information Management Association (AHIMA), and have participated in conferences held by CMS. They also participate in workgroups within those organizations. ViPS ICD-10 team members have provided ICD-10 awareness training to other ViPS IT teams, as well as to a number of external organizations, and it is our goal to complete awareness training for our organization in 2010.

For all of our products, we have scheduled the following time frame for our ICD-10 readiness initiative:

• Phase 1 – Assessment: we have begun initial assessments and will complete them by the end of 2010.
• Phase 2 - Planning, and Phase 3 - Remediation will occur in 2011 and 2012.
• Phase 4 – Implementation will occur in 2013.

We also understand the importance of communication and collaboration with customers, suppliers and other partners, to ensure success. In 2010, we will be communicating with our customers and collaborating on our implementations plans.

ViPS is dedicated to our customers and our customers' successes, and to that end, we will ensure that our organization provides ICD-10 compliant products to help our customers succeed. We will work with our customers to ensure that we - and they - achieve the maximum benefit from the ICD-10 code set.

HIPAA Readiness

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a significant healthcare reform law that passed Congress in 1996. The HIPAA law has its roots in the Clinton Health Reform proposal, and its primary purpose was to provide better access to health insurance as well as to toughen the law concerning healthcare billing fraud. There are other corollary sections of the HIPAA law related to administrative simplification and privacy of protected health information that have far-reaching effects for Providers, Payers, Managed Care Organizations, their business associates, and any entity storing, processing, and transmitting healthcare information.

HIPAA amends the Internal Revenue Code of 1986 by:

• Improving portability and continuity of health insurance coverage in group and individual markets
• Combating waste, fraud and abuse in health insurance and healthcare delivery
• Promoting the use of medical savings accounts
• Improving access to long-term care services and coverage
• Simplifying the administration of health insurance

In addition, HIPAA compliance includes provisions for improving and monitoring the security and confidentiality of any records containing health plan member and patient information. In 1998, the Department of Health and Human Services (HHS) proposed, as part of these HIPAA provisions, a Nation Standard Provider Identifier (NPI), a National Standard Employer Identifier and security standards for electronic health data.

The Administrative Simplification rules of HIPAA are intended to improve efficiency in healthcare delivery through standardized, electronic transmission of many administrative and financial transactions as well as protection of confidential health information.

For more information on HIPAA compliance, link to the HIPAA Advisory web site, by Phoenix Health Systems, at www.hipaadvisory.com.