Managing The Conversion To HIPAA 5010 No World Borders Webinar by Mike Arrigo
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On Monday, November 30th at 1pm ET Mike Arrigo, CEO of No World Borders, Inc. presented at a health care industry panel on HIPAA, electronic data standards and some specifics around implementing the EDI standard HIPAA 5010. "Moving from ICD-9 to ICD-10 coding is one of the toughest challenges facing the healthcare industry today, said Arrigo. "This webinar helps health plans prepare now by learning the key steps in transitioning to HIPAA 5010 standards," he continued. A panel of industry experts will convene for a 90 minute webinar on one of the most important topics in health care IT: "Managing the Conversion to 5010 HIPAA." Topics Mr. Arrigo will cover include 1) Organizational readiness 2) Process impacts, 3) Auditing of requirements, 4) Test plans, 5) Organizational impact, 6) Project planning. The panel covered several topics together, including: Pacing yourself for execution Keeping scheduling and communication a priority Maximizing returns Changing your transaction and code sets Budget vs. actual cost Tracking tools Recognizing the value in integration testing and piloting Pilot programs and test runs: When, how, who, and more Going live: Avoiding pitfalls through lessons learned New opportunities created by 5010 ROI potential for 5010 Reducing risks Presenters: Scott C. Cox, Associate Director, Navigant Consulting, Inc. Ed Hafner, Chief Technology Officer, Foresight Corporation Mike Arrigo, Managing Partner, No World Borders, Inc. Prasad Lokam, Chief Architect, Miracle Software Systems, Inc. Lisa Miller, XEO Health Rajiv Sabharwal, Chief Solutions Architect, Health and Life Sciences, Infosys
![Managing the Conversion to HIPAA 5010 Webinar November 30, 2009 1:00pm EST Mike Arrigo Managing Partner, CEO No World Borders, Inc. For more details, assessment info [email_address] (Please send from your payor or provider email domain address) http://www.noworldborders.com/HIPAA5010MigrationServices.html](https://image.slidesharecdn.com/20091130managingtheconversiontohipaa5010noworldborders-webinarfordist-091222014026-phpapp01/85/Managing-The-Conversion-To-HIPAA-5010-No-World-Borders-Webinar-by-Mike-Arrigo-1-320.jpg)
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Managing The Conversion To HIPAA 5010 No World Borders Webinar by Mike Arrigo
- 1. Managing the Conversion to HIPAA 5010 Webinar November 30, 2009 1:00pm EST Mike Arrigo Managing Partner, CEO No World Borders, Inc. For more details, assessment info [email_address] (Please send from your payor or provider email domain address) http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 4. HIPAA 5010 Process Impact http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 6. Impact of 5010 & ICD-10 on Process http://www.noworldborders.com/HIPAA5010MigrationServices.html Customer Service Product Development Revenue Management Reimbursement Management Finance & Administration Care Management Network Management Risk Management Member Services New Benefits Design Enrollment Claims Accounting Disease & Case Management Provider Contracting Rating Provider Services Product Setup & Configuration Billing & Receivables Fraud Detection Human Resources Utilization Management Network Management Underwriting Employer Services Billing Reconciliation Medicare/ Medicaid Financial Extracts Disease Management Claims Repricing Actuarial Broker Services Care Management Population Management
- 7. Visualize Current & Future To Ensure Alignment, Value http://www.noworldborders.com/HIPAA5010MigrationServices.html Claims Process Enterprise Infrastructure Services (Mainframe legacy, Portal, SOA, IDRS, LDAP, EAI, E-mail, IT Operations) Customer Service Product Dev Care Mgmt Revenue Mgmt Reimb Mgmt Finance SFA Prodict LMS Inv MGMT B2B product ERP. SCM productinfo. MES DB ERP CRM BPM models, simulates, executes, manages, monitors, & optimizes those Business Processes. Customer Service Product Development Care Management Revenue Mgmt Reimbursement Management Finance & HR SFA Product LMS Inv MGMT B2B Enterprise Infrastructure Services (Mainframe legacy, Portal, SOA, IDRS, LDAP, EAI, E-mail, IT Operations) product ERP SCM product MES DB ERP CRM Organizational Units Real-World Business Processes span organizations, systems, and applications. Product Offerings to Members Claims Management Customer Services Processes
- 9. Example Process Simulation http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 10. Example Process Model Artifact http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 12. HIPAA 5010 Organizational Impact http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 15. HIPAA 5010 Requirement Audits http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 19. HIPAA 5010 Testing http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 20. Testing Will Be Critical . . . http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 21. System Inventory, Test & Transition Plan (Sample Artifact) http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 22. Detail Test Framework (Sample Artifact) http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 23. HIPAA 5010 Planning http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 26. HIPAA 5010 Organizational Readiness http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 27. Achieving 5010: Organization Perspective http://www.noworldborders.com/HIPAA5010MigrationServices.html
- 34. Mike Arrigo Managing Partner, CEO No World Borders, Inc. For more details, assessment info [email_address] (Please send from your payor or provider email domain address) http://www.noworldborders.com/HIPAA5010MigrationServices.html
Editor's Notes
- Business Process Management is a natural starting point for implementing your SOA strategy with an initial project and in doing so extend the value of your existing underlying infrastructure. By service enabling your infrastructure you are enabling applications and infrastructure to work in support of the business process, instead of the applications and systems limiting the flexibility of how you do business. BPM in general seeks to Automate , manage & optimize dynamic business processes spanning organizations, systems & applications to create REAL business value. So how does it do that... Companies are structured by vertical organizations that perform discrete functions, i.e. HR, Finance, Manufacturing, Sales and Marketing, etc. IT fields applications and systems in support of the discrete functions of these organizations, i.e., CRM, SFA, Human Capital Management, Manufacturing Execution Systems, Supply Chain Management, etc. IT also fields horizontal infrastructure such as e-mail, portal, EAI, LDAP, etc. The reality is, however, that our business process span across these silos of discrete functions, applications and systems. As we service our customers, manufacture products, and administer the business, we engage people and systems across the board to complete complex processes. (Feel free to elaborate more on the problem from your own experience or from your customers’). BPM abstracts from the underlying physicality of those systems a process model, as you see here. In this picture, the orange symbols represent human steps and activities while the blue represent system-level interactions. A human interaction is treated just as elegantly as a system level interaction. BPM systems take these process diagrams and turn them into executable process applications without imposing changes to the underlying systems giving the business what is often referred to Agility, the ability to rapidly change based on business conditions. Information is sent and received to the right system or person, at the right time and in the right context for them to accomplish the task or tasks that make up the overall process. The BPM System keeps track of the state of the overall process (long running processes too…) and audits every single interaction every step of the way. This enables full control of how processes are executed, provides irrefutable documentation for compliance requirements, and allows business and process owners to view the state of their processes through sophisticated dashboards. Agreement on standards such as XML, BPMN and others in the web services world now enable us to cost effectively implement these solutions in weeks not years. These new process applications work in support of how the business people want to operate as opposed to being forced to operate as the application requests them to. Process models are now “should be” states not “has to be” states.