Ministry Health Care is a network of 15 hospitals in the American Midwest that places special attention on servicing the needs of lower-income families and their local communities. Their hospitals service more than 90,000 outpatients annually, with more than 455,000 total visits, and those providers have received awards from independent organizations such as HomeCare Elite, Hospitals & Health Networks Magazine, Leapfrog Group, and U.S. News and World Report.

Ministry approached QualiTest for assistance in ICD-10 compliance and migration, a process that entails switching all internal and external medical coding from the outdated ICD-9 system to an entirely new system.

With 15 different hospitals to address and compliance required by October 2015, Ministry was mostly concerned with ensuring a timely transition for their main internal systems, consisting primarily of 3M, GE Centricity, and MediTech.

QualiTest’s ICD-10 solution consists of six main facets:

  • Internal testing: Testing how information flows within the provider system; this process ensures that ICD-10 codes are processed correctly from beginning to end
  • External testing: Testing how transactions are sent and received between external trading partners such as payors, clearinghouses, billing services, etc. through channels already in use 
  • Revenue Impact Testing: This testing ensures that the processing of data, either under ICD-9 or ICD-10, does not negatively impact revenue generation, and that there are no vast differences in the revenue generated using ICD-9 and ICD-10 data
  • End-to-end business process testing: This testing ensures that the full spectrum of entities works together and meets the expectations of everyone involved (from doctors and patients to billing services and clearinghouses)
  • Clinical documentation improvement (CDI) testing and validation: Because ICD-10 can sometimes require more coding resources, this validates the appropriateness of, identifies deficiencies in, and recommends improvements to, the new coding protocols

The QualiTest Golden Data Set, a set of dual-coded medical records, and test automation accelerators were also used as part of the solution. The peer-reviewed data of the Golden Data Set eliminated the need for crosswalks or general equivalency mappings (GEMs), which can be costly, slow, and less effective than the QualiTest solution.

With the test automation accelerators, QualiTest improved speed and accuracy of data entry without the need for human input, effectively adding speed and efficiency to the testing process and lowering the potential for human error. By making use of these products, QualiTest was able to complete thorough testing of all necessary systems with plenty of time remaining until the October 2015 compliance deadline.

About the Author

 Yaron Kottler joined QualiTest in 1999 as a junior QA test engineer, progressing through multiple hands-on roles before transitioning to business development. In 2005, Mr. Kottler led the establishment of QualiTest Turkey before relocating to the USA in 2006 to establish QualiTest USA where he, today, he is the chief executive officer. Mr. Kottler holds a BA in Business Administration and IT from the IDC, Israel and an MBA from the Executive Program at the Hebrew University, Israel.

Contact the Author

Share This Article