Nalashaa’s 7030 Implementation Strategy
With enough knowledge on HIPAA 7030, let’s now look into ways to put this theoretical knowledge into practice; more specifically, let’s look into how Nalashaa implemented theory into practice.
Nalashaa Healthcare provides a complete suite of frameworks, tools, checklists that provide an end-to-end offering to the Healthcare plans for implementing the HIPAA 7030 version. HIPAA 7030 has to plug into the already being used edition of 5010. This upgrade requires an expert and systematic approach to achieve a successful implementation.
4 Phase Journey towards a Successful Implementation
Let’s go on an informative journey to get a complete understanding of the process towards a successful implementation in Nalashaa style.
The framework consists of well-defined components from Assessment to Transition phase. Each phase targets specific needs of the customers from Policy, Process, and Systems. The framework takes care of operational and strategic challenges involved in End-to-End services or products to ensure a smooth implementation.
Let’s get a better understanding of each phase.
Phase 1: Assessment
The assessment analysis phase will identify the impact of 7030 standards at various functional levels.
Nalashaa’s Assessment Framework will be carried out to understand the impacts of Policy, Process, and Systems at each business areas and levels. Product and Program level analysis will also be performed to understand the impact at various business and functional levels.
Nalashaa Solutions will provide the outcome of this phase to help the organizations to derive the accurate impacted areas along with the solution plans. The solutions will be defined based on the assessment analysis; also various other methodologies are used to derive a solid solution plan for the impact.
Phase 2: Solution
Solution execution phase entails Policy, Process and System changes using Nalashaa’s Solution execution model.
Based on the recommendations from the assessment phase, the project work plan will be developed. The project work plan covers all the tasks and activities needed to bring in the required changes without duplication and rework within a minimal timeframe. The work plan tasks are executed in a prearranged manner.
Effective remediation will reduce or eliminate the cost of rework. Solution changes can bring significant productivity improvement after systems remediation.
Phase 3: Validation
Nalashaa’s validation framework will be used to effectively and efficiently test all Policy, Process, and Systems with the changes executed.
Impact on Policy, Process, and Systems are huge due to 7030 implementation. Coverage of each and every 7030 changes needs to be tested as it carries immense importance in the business and functional levels.
This phase includes varies stages such as develop and execute test cases, review test results, generate results and status and various other stages. Generation of test data requires tremendous effort and thereby shoots up the testing cost exponentially. Hence, ready test scenarios and test cases have been developed and maintained which are used at various levels incorporating all the 7030 changes. HIPAA compliance and PHI guidelines will be taken care at all levels while testing real-time data against the changes incorporated.
Phase 4: Transition
This phase will cover dual processing of both 5010 and 7030 transactions over a period of time until the 5010 transactions version is phased out.
This will assist in managing different trading partners in sending different versions as they might migrate at different or later times. The production or transition phase will accommodate both the versions until 5010 is completely phased out. Any defects or discrepancies can be assessed and addressed in a timely manner during the transition phase.
The program management plan derived initially at the consulting phase will help monitor and track the progress of transactions through this phase. After the implementation, the cycle tracking methodology used by Nalashaa provides more visibility to the operational performance of HIPAA transactions.
So, before getting into action…
Moving from 5010 to 7030 transactions will have a huge effect on virtually every business process involved with EDI transactions. Based on industry estimates and our prior client experiences, it is vital for all healthcare organizations who handle EDI transactions to define a comprehensive strategy of the solution. Full-Service remediation of the current system changes and business process and policy changes are needed to be identified, assessed, planned and analyzed. Each approach has its merits and advantages and is most applicable to specific situations based on the organization’s needs. One has to weigh these approaches in the context of the organizations strategic business direction and its immediate key business drivers that demand appropriate solutions. It is imperative that all stakeholders thoroughly evaluate the scope and the opportunity before rolling out plans for 7030.
Our expertise and knowledge of standards position us well to help you with the transition to 7030.
Thejesh Kumar C
Thejesh Kumar C
Thejesh has vast experience in claim benefit management, ANSI X12 transactions, HL7, Medicare & Medicaid solutions, Enrolment and other key areas. He is an avid sports lover and has played professional cricket at the junior level. He also loves to travel in his free time.All stories by: Thejesh Kumar C