AuthentICD – Organizations migrating to ICD-10 have substantial risks to revenue continuity in addition to the strain on internal resources. The AuthentICD solution is an ICD-10 diagnosis and procedure test bed, natively coded, that accurately assesses any implementation approach to deliver comprehensive functionality that every covered entity will require to meet this challenge. It also provides predictive analysis of healthcare business and policy rules that covered entities utilize in troubleshooting their application systems.

The need for qualitative and quantitative data is the single most important component for a successful test strategy, test plan, and test execution. The best-laid plans will go awry if testing uses inaccurate or inadequate test data sets.

Software companies have developed tools, referred to as GEMs and crosswalks, to help with the tasks of converting data from ICD-9 to ICD-10. However, these tools are inherently flawed. GEMs and crosswalks are mapping tools, but they do not contain matches for all of the codes in both code sets. There are less than 4,000 exact matches among the 69,000 ICD-10 diagnosis codes and only 72 exact matches for the 71,000 procedure codes. ICD-10’s terminologies and concepts are also different from ICD-9, and thus cause inadvertent errors in the content of patient information. This presents challenges in achieving efficiency and accuracy in patient information. Test files must be generated through clinical-based medical records and natively coded in ICD-10.

Test data creation using a GEM or crosswalk will not provide an accurate representation of the both the frequency and validity of the test transactions. In addition, payers use different crosswalks, which results in variations in the outcomes of submitted claims and can wreak havoc on providers’ reimbursements. The Centers for Medicare & Medicaid Services recommends not using crosswalks for this reason.

By leveraging the medical and clinical expertise of our teams, we are the only testing organization in healthcare today that knows using mappers to test ICD-10 is a major mistake and will result in much more harm than good. ICD-10 must be clinically tested and using a tool based approach will fall well short of the insights, accuracy and correct medical representation of what will be delivered when ICD-10 goes live.

Only AuthentICD delivers exactly the features, functionality and clinical expertise needed to deliver the most accurate and truly the only viable testing approach for ICD-10. AuthentICD team is comprised of medical doctors, ICD-9 and ICD-10 coding experts, claim expertise, actuaries, underwriters and quality assurance professionals. This complete package of industry experts is available through our managed service and delivers the industry's highest value proposition.

Take the AuthentICD challenge!

We gladly accept any challenge in the accuracy and correct interpretation between AuthentICD and any vendor's tool based mapping product. Give us your top five ICD-9 codes and we'll provide back to your Chief Medical Officer highly accurate, medically and clinically reviewed ICD-10 coded transactions. Take those transactions and run them through any vendor's tool based approach and you'll experience first hand the power of AuthentICD.

AuthentICD = 95% - 100% accuracy rate of correct ICD-10 code interpretation

GEM and Tool Based Approach - = 30% - 60% accuracy rate of correct ICD-10 codes

Use our data to test all the vendors competing in your RFP's and AuthentICD will show you the gaps in their products and how much work your teams will have to get them accruate enough to be useful. Contact us today to request our ICD-10 vendor test packet for your use in determining the true capabilities of vendor's tool based appproaches.

Which approach do you want to trust for your implementation and testing efforts? AuthentICD is delivered as a highly affordable managed service with no tools to install and comes with our medical and clinical expertise to provide key insights into your ICD-10 implementation and testing.

Covered entities do have a choice.... conduct business using methodologies and tools based on the past or go with Qualedix QA and test with services specifically designed for the future.

AuthentICD Managed Service Components