RightCare ICD-10 Claim Testing

Submitted by jbrown on Wed, 05/27/2015 - 15:16

Date: May 27, 2015

In preparation for the ICD-10 implementation on October 1, 2015, RightCare from Scott & White Health Plan (RightCare) will be participating in a testing effort with our claims processing and clearinghouse vendors. RightCare is accepting all providers interested to assist in the testing process by submitting ICD-10 test claims to Emdeon. ICD-10 test claims may include 837I, 837P, 837D, UB-04, CMS-1500, and/or ADA 2012 claims. We will select all testing partners who are willing to participate.

The steps below outline the high level testing process:

1. Providers communicate interest to participate in testing by emailing mwcastillo@sw.org
2. RightCare will review the list of providers that respond with interest and will contact all providers with detailed testing instructions
3. Providers may submit up to 100 test claims through Emdeon using a test indicator. Alternatively, providers may submit up to 20 paper test claims through Emdeon
4. Providers document data about test claims in a validation form that will be provided by RightCare
5. Emdeon will deliver standard reports with a test indicator to providers based on existing reporting preferences
6. Test validation forms are sent to RightCare so that test claims can be tracked and outcomes can be documented during the testing process
7. Claim files that pass Emdeon edits will be made available for claim processing testing
8. Claim processing test results will be made available to providers
9. Providers send feedback and questions to RightCare as issues are identified

If you would like to participate in ICD-10 testing, please send an email confirming your interest to mwcastillo@sw.org by June 8, 2015. After confirming your interest, you will receive additional communications with detailed test procedures and dates in the coming weeks.