{"id":13251,"date":"2018-07-12T08:23:16","date_gmt":"2018-07-12T08:23:16","guid":{"rendered":"https:\/\/www.varshabi.com\/HCIM2\/?p=13251"},"modified":"2021-04-15T15:35:40","modified_gmt":"2021-04-15T15:35:40","slug":"southern-california-mso-using-ai-to-increase-claims-processing-productivity","status":"publish","type":"post","link":"https:\/\/www.varshabi.com\/HCIM2\/southern-california-mso-using-ai-to-increase-claims-processing-productivity\/","title":{"rendered":"Southern California MSO using AI to increase claims processing productivity"},"content":{"rendered":"

While many businesses are still looking for ways to harness new technology, Southern California Physicians Managed Care Services (SCPMCS) has been leveraging artificial intelligence to increase the productivity of their claims team since 2009. Using HCIM\u2019s SymKey\u00ae<\/a> solution, SCPMCS has been able to automate both routine and on-the-fly claims processing workflows for the past nine years.<\/p>\n

SCPMCS used SymKey\u00ae to assist in the processing of nearly 335k claims last year, which they estimated was equivalent to the workload of 3 full time employees (FTEs).<\/strong><\/em><\/p>\n

In addition to saving SCPMCS approximately 3 FTEs per year, the sheer speed of claims processing with SymKey\u00ae has ensured they maintain impressive turnaround times. Their claims team\u2019s confidence in the accuracy of claims processed with SymKey\u00ae allows them to focus on more complex tasks, resulting in efficient and streamlined claims operations.<\/p>\n

According to the SCPMCS claims team, their favorite SymKey\u00ae workflow scenario is Copy and Reverse, which allows them to create exact claim copies to rework paid claims and reverse them. This is particularly useful when CMS releases a retroactive fee schedule adjustment, because those Medicare FFS claims can be reprocessed quickly and accurately, with minimal human intervention. Learn More >><\/a><\/p>\n

\u201cDue to the high volume of reports we have created, we run SymKey\u00ae almost 24 hours per day. It really eliminates a lot of repetitive manual work,\u201d said Scott Fowler, Claims & Compliance Manager at SCPMCS.<\/p>\n

SymKey\u00ae features full sequencing and scheduling capabilities, which allows it to be run 24\/7. Strategically, SymKey\u00ae allows small to mid-sized healthcare payer organizations to grow with minimal disruption to their claims operations. SymKey\u00ae clients can increase their membership and process an ever-increasing number of claims without hiring more claims processors to work the additional claims. SymKey\u00ae can never be maxed out in capacity because clients can add additional processing engines to handle an influx of claims.<\/p>\n

\u201cBased on SCPMCS\u2019 FTE savings, we estimate that they realized a 110% return on their annual license fees,\u201d said Thomas Streeter, Senior Vice President, Product Solutions at HCIM. \u201cThis impressive ROI demonstrates how forward-thinking and innovative their claims operations team is, always looking for more workflows to automate with SymKey\u00ae robotic processing.\u201d<\/p>\n

After nine years as a valued SymKey\u00ae client, SCPMCS has continued to receive the attentive product support they\u2019ve come to expect from HCIM. \u201cWe are extremely pleased with SymKey\u00ae and have found HCIM\u2019s customer support to be outstanding,\u201d said Fowler.<\/p>\n

\u201cAt HCIM, we are passionately committed to our clients. I\u2019ve enjoyed our long-term partnership with SCPMCS and am pleased that they consistently embraced SymKey\u00ae as an integral component of their daily claims workflow. Their success is truly our success. I am delighted to see that they\u2019ve been able to achieve operational efficiencies year after year,\u201d said Michael Wilson, President & CEO of HCIM.<\/p>\n","protected":false},"excerpt":{"rendered":"

While many businesses are still looking for ways to harness new technology, Southern California Physicians Managed Care Services (SCPMCS) has been leveraging artificial intelligence to increase the productivity of their claims team since 2009. Using HCIM\u2019s SymKey\u00ae solution, SCPMCS has been able to automate both routine and on-the-fly claims processing workflows for the past nine […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,11,14],"tags":[38,36,32],"class_list":["post-13251","post","type-post","status-publish","format-standard","hentry","category-healthcare-information-management","category-recent-news","category-symkey","tag-blog","tag-hcim-clients","tag-technology"],"_links":{"self":[{"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/posts\/13251","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/comments?post=13251"}],"version-history":[{"count":3,"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/posts\/13251\/revisions"}],"predecessor-version":[{"id":17526,"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/posts\/13251\/revisions\/17526"}],"wp:attachment":[{"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/media?parent=13251"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/categories?post=13251"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/tags?post=13251"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}