Case Study: Tampa General Hospital validates end-to-end ICD-10 readiness with Optum’s RelayAssurance Plus

End-to-End ICD-10 Testing Pays Off for Tampa General

Tampa General Hospital, a 1,018‑bed not‑for‑profit level 1 trauma and transplant center serving a multi‑county region, needed to validate end‑to‑end ICD‑10 claims processing using historical production data without compromising PHI, identify potential DRG shifts, and mitigate adjudication issues ahead of the ICD‑10 go‑live. To address these challenges, Tampa General worked with Optum using RelayAssurance™ Plus (ePremis®) and Optum’s RelayHealth connectivity and no‑cost ICD‑10 testing program.

Optum helped TGH create a replica production environment and move flagged, recoded ICD‑10 837 test claims through RelayAssurance Plus (ePremis) and RelayHealth into payer test beds, enabling transparent, end‑to‑end testing. The tests ran smoothly, validated payer readiness and documentation/coding accuracy, uncovered an erroneous payer edit that would have caused hundreds of rejections, and revealed DRG shifts that prompted a collaborative deep dive — measurable outcomes that reduced risk and informed further ICD‑10 readiness work with Optum.

Tampa General Hospital

Gale Scott

EDI Regulatory Compliance Administrator