Partnership Readies Massachusetts for Transition to ICD-10, Highlights Value of External Testing

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Edifecs and Massachusetts Health Data Consortium Offer Collaborative Testing Tools and Support to Reduce Costs, Lower Risks

Today, Edifecs, Inc., a healthcare solutions company specializing in information management and compliance technology, announced a strategic partnership with the Massachusetts Health Data Consortium (MHDC). MHDC will leverage the Edifecs Collaborative Testing Solution to support its ICD-10 testing efforts for data transactions among providers and state health plans. The ICD-10 Collaborative Testing Program (CTP) will reduce the cost and time of testing, mitigate financial and compliance risk, and improve overall ICD-10 preparation among participants. Currently, eight health plans and nine provider organizations are engaged in the CTP, with more expected soon.

“The State of Massachusetts is commonly known for being a pioneer in healthcare coverage and accessibility – technology and collaboration are no exception. Edifecs will help our health plans and provider organizations achieve the ICD-10 milestone and set the national standard in ICD-10 testing,” said Denny Brennan, executive director of the Massachusetts Health Data Consortium. “With access to Edifecs’ collaborative testing tools and team of experts, the CTP will help members manage the magnitude of this project and mitigate any risk going into ICD-10 live production.”

Health plans and provider organizations must be in compliance with the ICD-10 mandate by October 1, 2014. The CTP will facilitate transaction, coding quality and business impact testing within trusted, web-based, payer-sponsored testing communities. CTP will maximize and encourage collaborative development with sharing of testing scenarios.

The Edifecs Collaborative Testing Solution is a secure, online testing portal that enables health plans and providers to jointly design testing requirements, share test data, exchange transactions and analyze results. This solution will allow the Commonwealth’s participating health plans and provider organizations to manage contracts and reimbursement rates with full transparency in expected financial outcomes for submitted claims and other transactions.

Because of its expertise and capability in enabling collaborative testing, Edifecs was named by MHDC as its technology partner. The platform will provide participating CTP organizations access to high quality clinical content (a repository of more than 1,500 clinical scenarios to cover high-risk codes) and a scalable technology backbone.

“We have seen that as the healthcare industry evolves and adapts to new mandates and regulations, testing is a critical component of all complex initiatives required to ensure a successful migration,” said Sunny Singh, CEO of Edifecs. “Our partnership with the Massachusetts Health Data Consortium will ensure testing between participating health plans and provider organizations is conducted properly so that both partners are prepared for the October 1 deadline with little variance to business and financial operations.”

About the ICD-10 Transition

The World Health Organization revises classifications almost every decade. Only a handful of nations—including the United States—have yet to embrace ICD-10, where adoption is required by October 1, 2014. The change is profound. On one hand, the new code set offers the many advantage of more granular clinical data capture. On the other, without proper systems migration, training and adoption, the new coding standard risks financial, clinical and administrative upheaval. One reason for the risk is the volume of additional information. ICD-9 consists of approximately 17,000 codes; however, ICD-10 includes more than 141,000 codes, encompassing a host of new diagnoses and procedures, which can provide more meaningful information about health conditions and surgical procedures for analysis and reporting.

About the Massachusetts Health Data Consortium

The Massachusetts Health Data Consortium, founded in 1978, is a not-for-profit organization working to address the myriad innovations in technology, data and analytics, health care delivery, finance, and public policy that will advance the value of health care in the Commonwealth for years to come. Its membership spans the state’s health care providers, health plans, life sciences organizations, industry associations and not-for-profits, state and federal health agencies, and healthcare technology and services organizations. Visit

About Edifecs, Inc.

An industry leader since 1996, Edifecs provides healthcare software solutions that improve operational performance by streamlining the exchange of information among health plans, hospitals, and other healthcare organizations, while enabling compliance with current mandates such as HIPAA, Operating Rules and ICD-10.

Today, more than 250 healthcare customers use Edifecs technology to unify transactions from any information channel source and input mechanism, while automating manual business processes such as enrollment, claims and payments management. Edifecs is headquartered in Bellevue, WA. For more information, please visit

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Kara Lundberg
Edifecs, Inc.
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