End-to-End Testing

Section 1104 of the Affordable Care Act (ACA) requires the adoption of new standards, operating rules, and identifiers in the upcoming years. In addition, the ACA requires health plans to certify compliance that they have adequate documentation that they are compliant with standards and operating rules and that they have completed end-to-end testing with their trading partners.  

To implement and fulfill the Administrative Simplification requirements, covered entities must perform many steps, such as, assessing their health information systems to determine how to accommodate the new Administrative Simplification requirements, making changes and testing the changes to their internal systems, and testing their systems with external trading partners to ensure the continuous exchange of administrative information.

Testing is essential to ensure compliance with the requirements adopted by the Secretary and ensure the uninterrupted flow of transactions with trading partners. Given the number of new requirements that covered entities will need to implement in the coming years, a process and tool to perform end-to-end testing is needed to aid the industry in meeting the compliance dates.

CMS Awards Contract to Develop Process for Administrative Simplification End-to-End Testing

On September 28, 2012, CMS awarded National Government Services (NGS) with a one-year contract to develop a process and methodology for End-to-End testing of the Administrative Simplification Requirements based on industry feedback and participation. This process will be an industry wide “Best Practice” for End-to-End testing that lays the ground work for a more efficient and less time consuming method for health care provider testing of future standards, leading to more rapid adoption of the future standards. While the goal is a process that can be used across all Administrative Simplification Requirements, ICD-10 will be the test case used during the pilot.

Industry participation is essential to this project, and industry can participate by becoming an industry collaboration partner, providing feedback in industry webinar sessions, or as a volunteer to pilot the end-to-end testing process.

To learn more about the End-to-End Testing project, please review the following ICD-10 checklists: payer, large provider, small provider, vendor to provider, and vendor to payer.  Or contact NGS at ngs.compliancetesting@wellpoint.com.