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ICD-10 Updates – Testing with Providers

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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.
 
End-to-End Testing 
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 
 
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