Client Spotlight on Foundation for Medical Care of Tulare & Kings Counties
In November 2014, Foundation for Medical Care of Tulare & Kings Counties (The Foundation) upgraded their claims management software and experienced a 75% drop in claims productivity. Their turnaround time went from 5-7 days to over 40 days within two months. At the prompting of HCIM, they began a 30-day SymKey® for EZ-CAP® trial in […]
New Virtual Examiner® and Claims Audit Tool™ Solution Suite Featuring SymKey® Automation
This past July, a large Medicaid health plan licensed the Virtual Examiner® (VE) and Claims Audit Tool™ (CAT) solution featuring SymKey® Virtual Auto-Post™ (VAP) automation for the QNXT™ claims system. This cost-effective integrated solution will help the client to realize potentially millions of dollars in overpayment and rework savings, and generate significant ROI. It will […]
Innovative Post-Payment SymKey® Uses
HCIM’s SymKey® clients are able to automate the post-payment reprocessing of claims in order to handle large volumes of claims without the need to hire additional claims staff. Some of these post-payment uses include: Applying CMS retroactive fee schedule changes Applying retroactive Provider contract fee schedule changes Identifying/correcting ineligible Providers/Vendors for services Correcting member eligibility […]
SymKey Wins 2014 Most Valuable Processor (MVP)
HCIM’s flagship SymKey® business process automation solution has had another banner year of processing professional and hospital claims. To see what kind of impact SymKey® had in 2014, we compiled statistics in a limited survey of 18 of our SymKey® clients. We found that for these clients alone in 2014, SymKey® achieved a return on investment […]
Addressing the Need for Business Process Automation in Healthcare Claims
Those who don’t analyze and improve on the mistakes of the past are doomed to repeat them. This is evidenced by the healthcare industry still being one of the very few industries that, despite the influx of technology available today, is still primarily a paper based industry, requiring some organizations to keep on hand large […]
How to Comply with ACA-Mandated Spending Thresholds
There has always been pressure to “do more with less” and continually reduce operational costs. Labor costs is always one of the largest administrative costs for health plans and managed care payers. I’ve found this to be true in my past positions running health plan operations centers and it continues to be true today. In […]
Reduce the Cost of Processing Healthcare Claims through Automation Technology
The December 2014 “State of the Payor” industry survey compiled responses from over 120 leaders from health plans across the United States. They found that over 88% of those surveyed are currently using or plan to use technology as the catalyst to transform their organization this year. More than 87% stated that stricter requirements resulting […]
SymKey’s Reprocess/Pend scenario is a perfect automated solution for adjusting paid EZ-CAP claims 6-10x faster than manually
The SymKey® Reprocess/Pend scenario (available via a query or TXT file) reprocesses EZ-CAP® status 9 paid claims by duplicating the claim and all detail lines, adjusting the original net pay of each line, re-pricing each claim line, adding a Processing Status note to reference the original claim, and then pending the duplicated claim to status […]
Tuality Health Alliance Leverages Integrated Suite of Automated Solutions
Tuality Health Alliance (Tuality) is a physician-hospital community organization that contracts with over a dozen health plans. Their physician membership includes approximately 80 primary-care physicians and 200 specialists. Tuality went live with SymKey® for Plexis Claims Manager™ in mid-July, 2014. Within the first month, they were processing an average of 400 claims per hour with […]
CIOReview Selects HCIM as 2014’s 20 Most Promising Healthcare Consulting Providers
HCIM honored as one of 2014’s Top 20 Most Promising Healthcare Consulting Providers by CIOReview, for its expertise in delivering technology solutions and consulting services to healthcare payers and managed care organizations HealthCare Information Management, Inc. (HCIM) was selected out of over 400 companies as one of the nation’s 20 Most Promising Healthcare Consulting Providers […]