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ICD-10 Updates – Testing with Providers

PW_E197903
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 Anthem 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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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use