SYS-CON MEDIA Authors: Pat Romanski, Elizabeth White, Glenn Rossman, Cynthia Dunlop, Peter Silva

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TriZetto Provider Solutions Prepares Providers for ICD-10

TriZetto Corporation today announced that its Provider Solutions Business unit has released a new tool that simplifies several important steps for providers’ ICD-10 preparation and helps reduce the risk of delayed or inaccurate reimbursement due to miscoded claims.

With just a few clicks, TriZetto Provider Solutions’ Top Codes Report charts out a provider’s most frequently billed procedure and diagnosis code pairs. Providers can then use a cross-walking tool, such as CMS’ GEMs or AAPC’s specialty crosswalks, to identify which ICD-10 codes correlate with their top ICD-9 codes.

“Understanding which ICD-10 codes your practice is most likely to use, and the degree of detail you will need in your patient charts to accurately assign these, is an important part of preparing for ICD,” said Jackie Griffin, associate vice president of client services at TriZetto Provider Solutions. “By comparing a list of the ICD-10 codes to patient charts, providers will be able to determine if their charts currently provide enough clinical documentation to correlate to the appropriate ICD-10 codes. If there is not enough documentation now, they can focus their ICD-10 training on preparing staff to record the necessary clinical documentation.”

The Top Codes Report is just one of the ways TriZetto Provider Solutions supports providers for ICD-10 preparedness. The clearinghouse introduced a secure ICD-10 self-test portal nearly a year in advance of the ICD-10 implementation deadline to ensure that all clients and partners receive dedicated time and attention from the team to test their ICD-10-coded claims. In addition, unlike many other clearinghouses, the company will continue to accept print image files even after the ICD-10 implementation, which will ease the transition for practices by eliminating the cost and hassle of upgrading to a 5010 claim format.

“At TriZetto Provider Solutions, we understand that the transition to ICD-10 can be overwhelming, so we are connecting providers with valuable insights and resources to help them manage this process more efficiently,” said Griffin. “One way we do this is by tapping the payer professionals at TriZetto to develop tools and help providers understand how to meet payers’ coding requirements to provide for more accurate reimbursement during and after the ICD-10 transition. The transition to a new code set is one of the biggest challenges for the healthcare industry in our lifetime, so collaboration between all healthcare entities will be vital to success.”

As part of its educational outreach, TriZetto Provider Solutions offers a number of ICD-10 resources, including a free ICD-10 Implementation Planning Worksheet that lists preparation steps for transitioning to ICD-10. Providers can find other resources to help support their ICD-10 implementation, including videos, webinars, FAQs and advice at www.gatewayedi.com/icd10.

About TriZetto Corporation

TriZetto Corporation provides world-class information technology and service solutions that help payers and providers work more efficiently and collaborate to deliver better health. TriZetto solutions touch over half the U.S. insured population and reach more than 200,000 care providers. TriZetto helps healthcare organizations enhance administrative efficiency; improve the cost, quality and delivery of care; address compliance; and compete to win in an emerging retail market. Payer solutions include benefits administration, care management, network management and portal platforms, as well as consulting, application management and business management services. Provider solutions include real-time eligibility assurance, claims editing, revenue cycle management technology and services that help providers get paid quickly and accurately. For more information, visit www.trizetto.com.

TriZetto Provider Solutions serves more than 200,000 providers across the country, equipping physicians, hospitals and health systems with the tools and information they need to simplify business processes and get accurate payments quickly. TriZetto Provider Solutions is built on the combined technology and experience of Gateway EDI, NHXS and ClaimLogic, and plays an important role in driving greater collaboration between providers and payers.

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