The transition to ICD-10 is much more than just a code set change for payors — it’s an entire revamping of an organization’s workflow. How will your organization handle two to four times as many claims errors during the transition? What tools do you have in place to triage those claims? How will you train your staff to efficiently route and resolve those claims? How will you accurately track your claims inventory to stay on top of your organization’s financial risk? What stage are you at with your ICD-10 planning? Will your EDI systems handle the 5010 standard? Let Legacy pinpoint your ICD-10 pain points, automate processes and optimize workflow to gain a competitive advantage.

ICD-10 Gap Analysis
Discover how the ICD-10 standard will impact your organization and develop a strategy for you to prepare based on a thorough gap analysis performed by Legacy that will:
Inventory systems and trading partners using claims data
Determine modifications and upgrades for systems, and assist with system selection when
replacement is necessary
Create training programs to improve clinical documentation, coding and reimbursement
management
Develop implementation timetables

Host System Configuration
The longer field length of ICD-10 codes requires modifications to databases, adjudication systems and other systems that utilize claims data. Legacy can help your organization configure its existing systems to accommodate these changes, or help with system selection when new systems are required. In addition, Legacy assists with business rule updates needed to use the new code set. Also, Legacy can help configure systems to simultaneously use both ICD-9 and ICD-10 codes during the transition and for accessing historical ICD-9 claims for analysis and rate setting.

Workflow Optimization
Quit bogging down host systems with repetitive user inquiries for data. Let your host system focus on adjudicating claims, and leverage Legacy’s AdminisTEP portal to handle inquiries and reporting in real time. AdminisTEP provides an efficient front end for your systems and adds functionality without increasing the workload of your host systems.

ICD-10 Claims Triaging
Claim errors are going to increase exponentially during the transition to ICD-10. Legacy has an efficient and cost-effective way for payors to triage claims and automatically route them to the most appropriate channel for resolution. This capability, called Exception Management, is built within Legacy’s AdminisTEP solution. It enables payors to handle claims, notify providers, manage inquiries and get claims rejected or reimbursed — all within the strict regulatory guidelines that mandate specific time periods for payor responses. Enhance provider relations by improving communications (claim status, etc.) with your network and by optimizing the reimbursement process. Features include:
Batch fixing of claims with similar errors
Automatically verifying claim syntax and format
Employing Data Correction and Review (DCR) teams (in-house or outsourced) to resolve claim issues

Reporting
Need to add new reporting functionality to your existing systems to keep pace with increasing demands and new challenges? Legacy has the tools to pull data from claims to create the reports your organization needs to address various business issues. Rather than navigating multiple systems that are difficult to use to get the information you need, Legacy can provide your organization with a front-end reporting portal that can accommodate the demands from thousands of users — all without bogging down your existing systems. Provide users with the information they need to make business decisions and reduce administrative costs in the process.