Case Study: Fortune 500 Multi-Line Health Care Enterprise achieves ICD-10 compliance and payment neutrality with HCL's proprietary ICD-10 tool suite

Multi-Line Health Care Enterprise - Customer Case Study

A Fortune 500 company that leads a multi-line health care enterprise—operating health plans in 12 US states and an independent licensee of the Blue Cross Blue Shield Association—faced ICD-10 regulatory compliance across multiple business and IT workflows. The customer engaged HCL to address complex mapping scenarios, maintain clinical and benefit equivalence, ensure payment neutrality, and avoid operational disruption during the ICD-10 transition.

HCL implemented its proprietary ICD-10 tool suite (consulting frameworks, mapping and testing tools), built custom rule engines and maps, and performed DRG shift analysis alongside end-to-end services from impact assessment to testing, coding and training. HCL’s approach delivered ICD-10 compliance while preserving clinical and payment neutrality, minimizing mapping and policy risks through data-driven analysis, and enabling a stable migration with customized testing and remediation.