ICD-10 Implementation, Consulting, and Conversion

ICD-10 Implementation, Consulting, and Conversion programs have changed since the first projects started in 2009.  For providers, in 2013 and 2014 we forecast more ICD-10 implementation consulting programs focused on first understanding the ICD-9 claims history via an ICD-10 financial risk assessment including ICD-10 analytics and ICD-10 clinical documentation via a chart review.  The implementation consulting effort for ICD-10 today must rely on tighter constraints.

Fast Start ICD-10

We started developing programs over five years ago in 2008 for health plans and providers.  When we set out to build our programs, we developed ICD-10 conversion plans that would include both internal claims and EDI infrastructure as well as contracted hospital facilities and physician practices. Though it seemed simple, this would not be easy because there are multiple systems and processes in the service chain between payors and providers.  We set out to build the best solutions in the industry, blending people, technology and a mix of payor– and provider–experienced consultants.

ICD-10 Continuing Education (CEU) and ICD-10 Continuing Medical Education (CME)

There are many facets to prioritize.  The types of training, executive leadership, board members, IT and operations staff, physician specialties, need training customized to their relevant role in the ICD-10 transition, timing of the training, who will train, and how training will be delivered, are factors.  We blend these considerations and deliver training to suit your needs including:

  1. ICD-10 physician specialty training (delivered at schedules to suit the physician schedule, on-site)
  2. Specific coder training whether inpatient, outpatient, or professional fee related
  3. Customized training addressing ICD-10 from a financial, IT, HIM, claims and billing team perspective
  4. Project governance training, largely overlooked by ICD-10 consulting teams and clients

We can deliver training via several modalities including:

  1. ICD-10 pre-recorded online training
  2. Live training via the web designed for interaction with the ICD-10 transition team
  3. On-site training by physicians, for physicians who need to know how their clinical documentation to support ICD-10

Rely on a Team that has the most ICD-10 Industry Experience to Answer Hard Questions

Our ICD-10 consulting team has trained over 700 providers and performed the first ICD-10 assessment in the country.  Our team can help determine how to customize the approach for your organization.  We look at several factors and help you answer key questions to do this:

  1. What will happen if I we do not start our preparation process for ICD-10 now?
  2. How do you set up a governance plan for ICD-10 with a communication plan to ensure the team knows who to go to for answers?
  3. What is the sense of urgency around ICD-10 implementation?
  4. What is the financial and reimbursement impact of ICD-10?
  5. How do we prioritize what should be done now for ICD-10 and what we can defer in our preparation?
  6. Which team members need training and how much ICD-10 training is right for each functional area?

 ICD-10 Consulting Capabilities – How to Start

Our team can build the governance structure to empower your internal team while setting up the subject matter expertise your organization needs.   We can help build ICD-10 work plans and timelines for each functional area of the organization.

Consulting, Implementation and ICD-10 Clinical Documentation Qualifications

No World Borders team of ICD-10 consulting experts are committed to consistently providing HIPAA Covered Entities whether health plan, hospital system, physician group, clearing house, or Health IT firm with the best ICD-10 Implementation, clinical documentation improvement, process improvement, IT systems assessment transition planning, ICD-10 double coding support, and training in the industry. We provide ICD-10 coding for hospital inpatient, ICD-10 coding for hospital outpatient, and ICD-10 coding for ICD-10 CM professional fees with CPT coding.  Our  industry leading team are certified by AAPC and AHIMA and ensure reduced reimbursement risk by blending this approach with analytics to narrow the amount of expensive manual processes to a focused group of physicians who represent the best time and financial investment for your valuable time and resources.

 

Michael F. Arrigo

Michael Arrigo brings four decades of experience in the software, financial services, and healthcare industries. In 2000, Mr. Arrigo founded No World Borders, a healthcare data, regulations, and economics firm with clients in the pharmaceutical, medical device, hospital, surgical center, physician group, diagnostic imaging, genetic testing, health IT, and health insurance markets. His expertise spans the federal health programs Medicare and Medicaid and private insurance. He advises Medicare Advantage Organizations who provide health insurance under Part C of the Medicare Act. Mr. Arrigo serves as an expert witness regarding medical coding and medical billing, fraud damages, as well as electronic health record software for the U.S. Department of Justice. He has valued well over $1 billion in medical billings in personal injury liens, medical malpractice, insurance fraud cases. The U.S. Court of Appeals considered Mr. Arrigo's opinion regarding loss amounts, vacating, and remanding sentencing in a fraud case. Mr. Arrigo provides expertise in the Medicare Secondary Payer Act, Medicare LCDs, anti-trust litigation, medical intellectual property and trade secrets, HIPAA privacy, health care electronic claim data Standards, physician compensation, Anti-Kickback Statute, Stark law, the Affordable Care Act, False Claims Act, and the ARRA HITECH Act. Arrigo advises investors on merger and acquisition (M&A) diligence in the healthcare industry on transactions cumulatively valued at over $1 billion. Mr. Arrigo spent over ten years in Silicon Valley software firms in roles from Product Manager to CEO. He was product manager for a leading-edge database technology joint venture that became commercialized as Microsoft SQL Server, Vice President of Marketing for a software company when it grew from under $2 million in revenue to a $50 million acquisition by a company now merged into Cincom Systems, hired by private equity investors to serve as Vice President of Marketing for a secure email software company until its acquisition and multi $million investor exit by a company now merged into Axway Software SA (Euronext: AXW.PA), and CEO of one of the first cloud-based billing software companies, licensing its technology to Citrix Systems (NASDAQ: CTXS). Later, before entering the healthcare industry, he joined Fortune 500 company Fidelity National Financial (NYSE: FNF) as a Vice President, overseeing eCommerce solutions for the mortgage banking industry. While serving as a Vice President at Fortune 500 company First American Financial (NYSE: FAF), he oversaw eCommerce and regulatory compliance technology initiatives for top ten mortgage banks and led the Sarbanes Oxley Act Section 302 internal controls IT audit for the company, supporting Section 404 of the Sarbanes Oxley Act. Mr. Arrigo earned his Bachelor of Science in Business Administration from the University of Southern California. Before that, he studied computer science, statistics, and economics at the University of California, Irvine. His post-graduate studies include biomedical ethics at Harvard Medical School, biomedical informatics at Stanford Medical School, blockchain and crypto economics at the Massachusetts Institute of Technology, and training as a Certified Professional Medical Auditor (CPMA). Mr. Arrigo is qualified to serve as a director due to his experience in healthcare data, regulations, and economics, his leadership roles in software and financial services public companies, and his healthcare M&A diligence and public company regulatory experience. Mr. Arrigo is quoted in The Wall Street Journal, Fortune Magazine, Kaiser Health News, Consumer Affairs, National Public Radio (NPR), NBC News Houston, USA Today / Milwaukee Journal Sentinel, Medical Economics, Capitol ForumThe Daily Beast, the Lund Report, Inside Higher Ed, New England Psychologist, and other press and media outlets. He authored a peer-reviewed article regarding clinical documentation quality to support accurate medical coding, billing, and good patient care, published by Healthcare Financial Management Association (HFMA) and is published in Healthcare IT News.

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