{"id":9859,"date":"2016-05-31T13:39:32","date_gmt":"2016-05-31T20:39:32","guid":{"rendered":"http:\/\/www.hcim.com\/?p=9859"},"modified":"2020-02-26T22:39:03","modified_gmt":"2020-02-26T22:39:03","slug":"client-spotlight-on-northwest-physicians-network","status":"publish","type":"post","link":"https:\/\/www.varshabi.com\/HCIM\/2016\/05\/31\/client-spotlight-on-northwest-physicians-network\/","title":{"rendered":"Client Spotlight on Northwest Physicians Network"},"content":{"rendered":"<p>During a year of rapid growth, Northwest Physicians Network (NPN) doubled the size of their Provider network and drastically increased their membership. With plans to take on one or two more health plans next year, they decided to get ahead of the additional workload by licensing SymKey<sup>\u00ae<\/sup> to increase their claims auto-adjudication rate through robotic automation.<\/p>\n<p>\u201cWe decided that 2016 would be the year of efficiencies,\u201d said Joanne Doss, Claims Delegation Program Manager at NPN. \u201cI\u2019d estimate that before SymKey<sup>\u00ae<\/sup>, somewhere around 95% of our claims were manually touched in some way. So we decided to let SymKey<sup>\u00ae<\/sup> handle the mundane work, which would allow our processors to focus on analyzing and adjudicating the more complex claims.\u201d<\/p>\n<p>\u201cWe had an idea of what SymKey<sup>\u00ae<\/sup> could do from talking to other users, so we went into it pretty prepared,\u201d said Doss. \u201cWe had meetings with the processors and asked what they did manually, then we built a spreadsheet of the manual processes to automate. We keep adding to that list as we go.\u201d<\/p>\n<h2>SymKey<sup>\u00ae<\/sup> Performance<\/h2>\n<p>NPN is currently on EZ-CAP<sup>\u00ae<\/sup> 6.x and has been experiencing average SymKey<sup>\u00ae<\/sup> processing speeds of 235 Professional Claims per hour and 125 Hospital Claims per hour. They schedule SymKey<sup>\u00ae<\/sup> to run every evening so it processes the claims before the claims examiners come in each morning.<\/p>\n<h2>Favorite SymKey<sup>\u00ae<\/sup> Scenario<\/h2>\n<p>\u201cSo far my favorite scenario has been addressing the bundled non-covered codes, which was nothing but adding an adjustment code and was such a waste of time for an adjudicator. SymKey<sup>\u00ae<\/sup> has really helped to eliminate that manual process,\u201d said Tammie Wood, Claims Systems Analyst at NPN.<\/p>\n<h2>Customer Service<\/h2>\n<p>\u201cAll the individuals we\u2019ve worked with at HCIM have been stellar. They\u2019re just good people, which is rare,\u201d said Doss.<\/p>\n<h2>Their Advice?<\/h2>\n<p>\u201cPreparation is key,\u201d said Doss. \u201cMeet with your team prior to the implementation and have a conversation about what they do manually so you can build your wish list. It\u2019s hard for claims processors to think about these mundane manual processes off the top of their heads, so they should take notes throughout their day to add more scenarios to the list.\u201d<\/p>\n<p>\u201cIt was a delight to work with Joanne and Tammie at NPN,\u201d said Thomas Streeter, Senior VP, Product Solutions. \u201cI was extremely pleased at how organized and prepared they were with documented scenarios, ready to discuss what they wanted SymKey<sup>\u00ae<\/sup> to do. That made the time on-site extremely productive.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>During a year of rapid growth, Northwest Physicians Network (NPN) doubled the size of their Provider network and drastically increased their membership. With plans to take on one or two more health plans next year, they decided to get ahead of the additional workload by licensing SymKey\u00ae to increase their claims auto-adjudication rate through robotic [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":9860,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,14],"tags":[21],"class_list":["post-9859","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthcare-information-management","category-symkey","tag-client-spotlights"],"_links":{"self":[{"href":"https:\/\/www.varshabi.com\/HCIM\/wp-json\/wp\/v2\/posts\/9859","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.varshabi.com\/HCIM\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.varshabi.com\/HCIM\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.varshabi.com\/HCIM\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.varshabi.com\/HCIM\/wp-json\/wp\/v2\/comments?post=9859"}],"version-history":[{"count":1,"href":"https:\/\/www.varshabi.com\/HCIM\/wp-json\/wp\/v2\/posts\/9859\/revisions"}],"predecessor-version":[{"id":16467,"href":"https:\/\/www.varshabi.com\/HCIM\/wp-json\/wp\/v2\/posts\/9859\/revisions\/16467"}],"wp:attachment":[{"href":"https:\/\/www.varshabi.com\/HCIM\/wp-json\/wp\/v2\/media?parent=9859"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.varshabi.com\/HCIM\/wp-json\/wp\/v2\/categories?post=9859"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.varshabi.com\/HCIM\/wp-json\/wp\/v2\/tags?post=9859"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}