A Checklist for your HIPAA 5010 Journey
Upgrading healthcare systems to HIPAA 5010 standards involves a thorough analysis of processes and systems to assess their impact on health plans, providers and clearing houses.
Infosys’ expert blogs on two approaches for a smooth transition to HIPAA 5010 –
Tactical approach
In this approach, organizations need to downgrade inbound 5010 transactions to 4010, pass the downgraded version through downstream applications for processing, upgrade the returning documents to 5010, and finally, push it through the Electronic Data Interchange (EDI) gateway.
Strategic approach
From a strategic standpoint, organizations need to remediate all downstream applications – core, transactional and peripheral – to comply with the mandate. They have to focus on back-end processes such as claims adjudication engine and eligibility system rather than the front-end EDI gateway or mapper software.
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A majority of organizations are not geared to meet the deadline of January 1, 2012. It makes eminent sense to implement an interim solution.
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Our expert shares a high-level checklist of crucial components for organizations that are adopting the tactical approach.
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The assessment and remediation of changes - possibly, running into millions of lines of code - can be navigated with a comprehensive testing strategy and automation tools.
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Author
Rajiv Sabharwal provides functional and architectural guidance to the healthcare and life sciences units at Infosys. He has been the chief architect for several solutions. In addition, he has managed more than 80 projects of various sizes, across several business areas and technology platforms. Rajiv has extensive experience in application development and solution architecting. He can be reached at Rajiv_Sabharwal01@infosys.com.
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