ICD-10 Updates – Testing with Providers
We are conducting File Validation Testing for providers who are EDI direct submitters. We have chosen TIBCO Validator® as our primary testing tool that offers unlimited testing of your EDI HIPAA transactions. This self-guided, web-based processing application is equipped to test file formats and edits as they pertain to ICD-10.
To get started
, visit our BCBSGa EDI Webpage
where you will find the “Free On-Line HIPAA Validation Testing” link to register for Validator® and more information and the guidelines for using the tool.
If you are not an EDI direct submitter, Validator® is available to your claims submission vendor (clearinghouse, billing company, etc.) for unlimited testing. Ask your claims submission vendor about the results of testing with us.
As you develop your ICD-10 testing strategy, here are some suggested best practices to consider:
| Use real medical records to test systems. Make sure you're testing the types of cases you will actually be treating and submitting for reimbursement.|
| Submit test data that reflects your actual case load volume. |
| Dual coding will help create test data that can be used.|
| Have the documentation available that supports your test ICD-10 codes. |
An End-to-End test of our systems and business functions which demonstrates ICD-10 readiness levels both internally and externally is underway. The End-to-End Testing effort engages selected providers, hospitals and data trading partners to help ensure we are ready for ICD-10 across the industry. We will share guidance and learning gained from these tests with you as we prepare for ICD-10.
Outcomes of Testing
Through this testing, we will verify:
1. Claims files are correctly processed in our Electronic Data Interchange (EDI) Gateway.
2. Claims are correctly processed through the transaction flow of platforms/systems.
3. Claims are correctly coded for ICD-10.
4. Claims are correctly processed for expected business outcomes