News | October 7, 2013

TriZetto Provider Solutions Announces ICD-10 Testing Schedule

TriZetto Provider Solutions, which encompasses Gateway EDI, ClaimLogic and NHXS, announced that clients can begin testing their 5010 professional claims for ICD-10 readiness beginning on October 15, 2013, nearly a year in advance of the ICD-10 implementation deadline. Claims testing will be a critical step as providers prepare their practices to transition to ICD-10, and will help providers reduce the risk of payment delays once ICD-10 takes effect.

Clients can begin testing 5010 professional claims on October 15, 2013, and 5010 institutional and dental claims on December 1, 2013. 4010 claims, print image claims and NSF professional claims can be submitted beginning December 31, 2013. Unlike most clearinghouses, TriZetto Provider Solutions will continue to accept inbound claims in various pre-5010 formats and will convert them to the ICD-10 compliant version. In order to convert these claims, physician offices must send the necessary ICD-10 code along with their pre-5010 formatted claims.

“We’ve taken a very strategic, planned approach to our ICD-10 testing to provide that all of our clients, regardless of their claims file types, receive dedicated time and attention from our team,” said Chris Hunter, senior vice president and provider market president at TriZetto. “This staggered testing rollout will enable us to give our clients time to test their claims, identify errors and modify their processes in an effort to be ICD-10 compliant.”

In addition to testing provider claim files, TriZetto Provider Solutions helps providers manage the ICD-10 transition with practice management software vendor and payer testing. The company also offers educational resources and a dedicated team of knowledgeable EDI specialists to provide heightened client support. The ICD-10Insight website serves as a one-stop resource for important information about the transition, including frequently asked questions, videos, webinars and news updates.

“The move to ICD-10 is one of the biggest business challenges for the healthcare industry in our lifetime. These challenges, combined with all of the complexities of care delivery, can be overwhelming,” said Dr. Jeffrey Rose, chief medical information officer at TriZetto Provider Solutions. “While testing claims is an essential step in the ICD-10 transition process, TriZetto Provider Solutions is committed to supporting our clients through this critical change. We encourage providers everywhere to begin preparing for ICD-10 now to avoid negative impacts to their business.”

To help all providers navigate ICD-10, TriZetto Provider Solutions offers a free ICD-10 Implementation Planning Worksheet, which includes a list of preparation steps and suggested timeline for transitioning to ICD-10. Providers can also find other helpful ICD-10 resources at

TriZetto Provider Solutions serves more than 200,000 providers across the country, equipping physicians, hospitals and health systems with the tools and information they need to simplify business processes and get accurate payments quickly. TriZetto Provider Solutions is built on the combined technology and experience of Gateway EDI, NHXS and ClaimLogic, and plays an important role in driving greater collaboration between providers and payers.

About TriZetto
TriZetto provides world-class information technology and service solutions that help payers and providers work more efficiently and collaborate to deliver better health. TriZetto solutions touch over half the U.S. insured population and reach more than 200,000 care providers. TriZetto helps healthcare organizations enhance administrative efficiency; improve the cost, quality and delivery of care; address compliance; and compete to win in an emerging retail market. Payer solutions include benefits administration, care management, network management and portal platforms, as well as consulting, application management and business management services. Provider solutions include real-time eligibility assurance, claims editing, revenue cycle management technology and services that help providers get paid quickly and accurately. For more information, visit

Source: TriZetto Provider Solutions