Microsoft Helps Leading Health Organizations Prepare for ICD-10 Mandate
REDMOND, WASH. - Microsoft Corp. announced in a press release that multiple payer, provider and partner organizations, including Molina Healthcare Inc., EmblemHealth, Edifecs, Evolute, Neudesic LLC, The TriZetto Group Inc. and Washington Publishing Company are standardizing on Microsofts integrated, standards-based platform, with Microsoft BizTalk Server 2009 at the core, to support HIPAA 5010 and ICD-10 compliance. The platform also enables health plans to reduce costs and accelerate and automate processes and workflows to achieve administrative simplification.
BizTalk Server 2009 is a scalable electronic data interchange and messaging solution that helps payer and provider organizations meet the challenges of integrating diverse systems. It provides out-of-the-box support for HIPAA 5010 messaging schemas, trading partner management and integration components, while also enabling payer and providers to make better use of existing technology to support growth and reduce costs.
Our business needs were two-fold. We wanted to use existing technology to reduce administrative costs and simplify customer interactions and also needed a way to meet new guidelines related to security and transaction standards in HIPAA 5010, said Amir Desai, chief information officer, Molina Healthcare. Working with Microsoft, we chose a fixed-licensing solution based on BizTalk Server 2009 and Microsoft Office SharePoint Server 2007. Now, in addition to many other benefits in line with our organizations business goals, we will be HIPAA 5010 compliant at a fraction of what we would have spent on building a system.
Microsoft and leading partners, including The TriZetto Group Inc., Neudesic LLC, Evolute, Washington Publishing Company and Edifecs, are collaborating to help payers and providers embrace a service-oriented approach to HIPAA 5010 while creating a longer term IT strategy to support administrative simplification, health reform, ICD-10 adoption and new health IT models.
In light of the switch to HIPAA 5010 and the replacement of ICD-9, payers and providers throughout the country are struggling to find a cost-effective approach to meet these deadlines, said Dennis Schmuland, director, US Health Plans Industry Solutions, Microsoft. By allowing healthcare organizations to get more out of their existing investments and minimize the cost of integrating new pieces of technology, the Microsoft platform helps payers and providers easily meet HIPAA 5010 compliance while achieving administrative simplification.
Furthermore, to meet the new medical loss ratio minimums that, under health reform, compete directly with profit margins, health plans must find innovative ways to quickly drive down administrative costs, fraud, process waste, and the complexities of doing business. By using BizTalk Server to convert HIPAA 5010 transactions into electronic documents that are human- and machine-readable, health plans can redesign and automate labor intense and error-prone processes by tightly coupling administrative transactions with customer service, medical management and financial processes including claims auditing, investigations, authorizations, referrals, fraud and abuse, utilization management, appeals/grievances, online sales, enrollment, and customer service.
Coupled with platform technologies, such as Microsoft SQL Server 2008 and Microsoft Office SharePoint Server 2007, the Microsoft platform provides straightforward ICD-10 compliance so that it can be sent and received in time for the October 2013 deadline. It also integrates with the entire suite of Microsoft tools and interoperates with legacy applications and Java-based platforms, so the organizations legacy systems can be integrated into the platform.
Founded in 1975, Microsoft is the worldwide leader in software, services and solutions that help people and businesses realize their full potential.
