Health Plan Selects No World Borders to Review its HIPAA 5010 Electronic Data Interchange and ICD-10 Medical Coding Plans

May 19, 2010 (PRLEAP.COM) Health News
No World Borders, Inc., a health care IT and management consulting firm today announced that its Readiness Audit Framework and services have been selected by one of the largest health insurance companies in the nation to review its electronic data interchange (EDI) plans in advance of the health care reform, ARRA, and mandated compliance deadlines to support the move to efficient paperless health care claims. Once the project is completed, the client will be in position to begin implementation of the new mandated medical coding standard ICD-10.

No World Borders was selected in part for its deep consulting expertise in HIPAA 5010 and ICD-10, and its software as a service readiness framework which speeds the process of gathering, analyzing, and summarizing information across a large enterprise to find compliance issues, risks, and best practices among line of business and IT groups.

The No World Borders Readiness Audit Framework has been tested and used in a variety of uses for both HIPAA 5010 and ICD-10. Under the contract, No World Borders is reviewing the client's plans for EDI HIPAA X12 5010 and ICD-10 that involve both next-generation core computer systems and existing systems. The systems include the enterprise health care administration platform, health management system, as well as mainframe claims systems.

"This contract is further validation of our HIPAA 5010 and ICD-10 Readiness Methodology as a partner to independent Blue Cross and Blue Shield organizations and other health plans across the country"

"This review is part of a plan that will help our client meet their goal of improving service to members, employers and providers," said Michael Arrigo, President & CEO of No World Borders. The review of HIPAA 5010 and ICD-10 requirements helps ensure the lowest cost and lowest risk in deploying their IT resources to meet state and federal requirements, including those that may result from healthcare reform. This provides clients the flexibility they need to take advantage of benefits in the new 5010 transactions and ICD-10 medical coding standard, accommodate new products and to meet the business needs of their customers."

The relationship encompasses personal communication to resolve questions, problems or concerns. "Our agreement with the company is yet another example of a customer seeing significant benefits from our expertise in HIPAA 5010 and ICD-10," noted Robert Francis, practice leader for health care at of No World Borders.
"These clients range from large national payers and Blues plans to local and regional payers. While there are business requirements unique to each, our payer customers all benefit from attentive, flexible and cost-effective consulting from No World Borders that allows them to focus on their core competencies of health insurance services, member health management and strong service to their many constituents," he continued. "We include business, system, process, and people components of our web based assessment and we find both the successful points and risks in client implementations rapidly and cost effectively, aggregating and reporting the information using our technology and experts to provide unprecedented value to clients."

About The Readiness Audit Framework

The No World Borders Readiness Audit Framework includes a Software as a Service (SaaS) web based data collection and surveys, strategic business consulting services, and Service Oriented Architecture (SOA) IT healthcare consultants as a complete solution for health care insurance and health care providers. The readiness deliverables include findings and recommendations including a customized report. The report may include a combination of client selected components. These include: Business Roadmap Development, ICD-10 Organizational Impact Assessment, HIPAA 5010 Organization Impact Assessment, Business Process Review, Readiness Rating, Health Care Trading Partner and Clearing House Compliance, High Level Planning recommendations, Training and HIPAA Testing recommendations, Business Analytics needs assessment, Claims Software Vendor Readiness Assessment, Medical Coding Data Usage Analytics, Standards Requirements Gap Analysis, ICD-10 Implementation Plans, and most importantly a Risk Assessment relative to both meeting regulatory compliance dates and IT implementation risks.

The review may include identification of important compliance issues such as Public Health Information (PHI) violations, and use of outdated "identifiers" for health care providers by location, or government-funded programs that require different payment schedules.
The methodology not only provides a report, but helps encourage knowledge sharing among groups to ensure that new innovations, insights and course corrections are instantiated into the organization. Knowledge transfer sessions are conducted at the end of a Readiness Review to help finalize requirements, assist in prioritizing trading partner planning, and help Subject Matter Experts gain actionable strategies that they can use immediately to help reduce risk and manage cost in their implementation efforts. Additionally, No World Borders health care strategy consultants can help health care companies establish a Business Roadmap that helps improve business and IT alignment to ensure better outcomes for its clients.

About No World Borders

Founded in 2000, No World Borders is a leading privately held healthcare management and IT consulting company. Its team consults to firms who serve over one third of the U.S. insured population. The company has expertise in HIPAA 5010 electronic data interchange, the ICD-10 medical coding standard, implementation of enterprise software, and HIPAA Compliance Watch® which monitors changes in healthcare reform and advises companies on the IT and business impact, and HIPPA quality assurance. No World Borders helps clients see opportunities in regulatory changes to innovate, rather than seeing them as strictly a cost of doing business. Its mission is to help payers and healthcare providers optimize their operations, and bring to market new products that drive competitive differentiation to serve the health care consumer. The company strives to be agnostic in its approach, helping clients make the best choices in planning for health care reform and new electronic data and coding standards. The company is a member of WEDI, the health care industry's Workgroup for Electronic Data Interchange.