SymKey® for Plexis Claims Manager™
SymKey® for Plexis Claims Manager™ (PCM) was released on May 1, 2012, and will be demonstrated via webinar in August 2012 and at the upcoming Plexis 2012 User Conference, Sept. 9-12. Ashland, Oregon-based Plexis Healthcare Systems (Plexis) has partnered with HCIM to identify potential SymKey® for PCM pilot sites. Together, HCIM and Plexis surveyed a […]
Spotlight on Desert Oasis Healthcare (DOHC)
Desert Oasis Healthcare (DOHC), a subsidiary of Heritage Provider Network, Inc., licensed the SymKey® 2.0 for EZ-CAP® 6.x Virtual Auto-Post™ (VAP) module on May 1, 2012. VAP automates the posting of PCG Software Inc.’s Virtual Examiner®/Reporter® (VE/VR) claims recommendations into the EZ-CAP® system. “We were looking to increase examiner production by having edits automatically applied […]
PSW Seeing 3X ROI with SymKey for EZ-CAP
Olympia-based Physicians of Southwest Washington (PSW) licensed the SymKey® for EZ-CAP® Professional and Hospital Claims modules for a three-year licensing period in August 2011, after a successful 30-day Risk Free Trial. Here’s what Tamra Ruymann, Claims Manager at PSW has to say about SymKey: Return on Investment “SymKey’s price tag was unbelievable! I didn’t think […]
SymKey Saves the Day at NAMM-IL
The Problem North American Medical Management of Illinois, Inc. (NAMM-IL) was recently impacted by a retroactive fee schedule change that involved processing over 300,000 claims on top of their current workload! A project of this magnitude threatened to bring their normal day-to-day operations to a standstill as staff would’ve had to pour thousands of hours […]
FAQ: The 2010 CMS Fee Schedule was released and is effective retroactively. We have already paid claims for the last several months that now need to be repriced. Can SymKey automatically reprice them?
Yes, SymKey’s “Reprocess/Pend” standard scenario is a perfect automated solution for repricing paid claims and is very simple to use for EZ-CAP status 9 claims. Create a .txt file with a list of the paid claim numbers that need to be repriced Open the SymKey Professional Claims module Check the “Reprocess/Pend” checkbox about ¾ the […]
FAQ: How can we expand our use of SymKey to handle more claims?
Answer: This is a four-step process: Identify the type of claims that you would like to target (i.e. denying claims that exceed a timely filing threshold). Define what claims fall into this scenario (i.e. timely filing claims may be in-network providers as defined by the “ZZZ” in the Provider Contract field, where the date received […]
FAQ: Can SymKey move claims within EZ-CAP to a status beyond 3?
Answer: SymKey for EZ-CAP is designed to work within EZ-CAP’s Professional and Hospital claims modules. As a result, it is able to automate the moving of claims that are in status 1-7 to a status 1 or 3. It can also reprocess status 9 claims by creating a new claim number, entering all related detail line information, and […]
Can BPA help you ditch the Sticky Notes?
During my time spent as an Operations Manager, I remember that my claims processors had sticky notes all over their monitors and cheat sheets that they would use to remind them of manual or special processes for certain providers or members. Not everyone had the same sticky notes, nor did they all have the same handwritten […]