{"id":22196,"date":"2024-07-15T18:17:21","date_gmt":"2024-07-15T18:17:21","guid":{"rendered":"https:\/\/www.varshabi.com\/HCIM2\/?p=22196"},"modified":"2024-07-15T18:17:21","modified_gmt":"2024-07-15T18:17:21","slug":"symkey-unlocks-tackling-cob-head-on","status":"publish","type":"post","link":"https:\/\/www.varshabi.com\/HCIM2\/symkey-unlocks-tackling-cob-head-on\/","title":{"rendered":"SymKey Unlocks: Tackling COB Head-on"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"22196\" class=\"elementor elementor-22196\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a00fbf9 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a00fbf9\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-953a2e3\" data-id=\"953a2e3\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c5f50f3 elementor-widget elementor-widget-heading\" data-id=\"c5f50f3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">The COB Challenge<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d144658 elementor-widget elementor-widget-text-editor\" data-id=\"d144658\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Coordination of Benefits (COB) \u2013 the perpetual headache for healthcare payers. Manual processes, incomplete member questionnaires, and the eternal struggle of determining the order of benefits. The result? Delayed payments, increase in appeals such as over payment and under payment of claims, and an increase of claim pend ratio.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d9c6705 elementor-widget elementor-widget-heading\" data-id=\"d9c6705\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">System Limitations<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9b38377 elementor-widget elementor-widget-text-editor\" data-id=\"9b38377\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Many core claims systems do not automatically import COB information from EDI files or calculate COB amounts for you. Even with sophisticated systems, the key details \u2014 prior paid adjusted amounts, copays, coinsurance, non-payable expenses, and contractual write off amounts \u2014 often stay hidden within the complex data structure of the EDI file, causing unnecessary complications.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b15e58e elementor-widget elementor-widget-heading\" data-id=\"b15e58e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">SymKey\u2019s Tactical Approach<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2e3aa62 elementor-widget elementor-widget-text-editor\" data-id=\"2e3aa62\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>SymKey doesn\u2019t just identify the problem; it solves it. The solution is straightforward: leveraging intelligent queries to identify claims with COB, processing them based on the client\u2019s business requirements, and automating adjustments. \u00a0No more manual hunting for information from EDI viewers or painstakingly calculating adjustments. SymKey intelligently adjusts amounts based on adjustments and financial responsibilities, streamlining the entire process.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5c2b5e6 elementor-widget elementor-widget-heading\" data-id=\"5c2b5e6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">SymKey for EZ-CAP Process Overview:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c094dc1 elementor-align-start elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"c094dc1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-circle\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Query EZDATAREP for Professional and Hospital EDI claim information.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-circle\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Extract COB details from 2430 SVD and CAS Segments.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-circle\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Calculate necessary adjustments on EZ-CAP claims.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-circle\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Apply Patient Responsibility as the new Contract Value and Net Pay amount.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-circle\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Assign appropriate CARC and RARC codes.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-79486e7 elementor-widget elementor-widget-heading\" data-id=\"79486e7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">The Results<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e53efec elementor-widget elementor-widget-text-editor\" data-id=\"e53efec\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The real victory here? Relief from the laborious process of hunting down EDI adjusted amounts, calculating changes for each claim line manually. SymKey isn&#8217;t just a solution; it&#8217;s a strategic move to eliminate manual processes and inefficiencies, decrease pend ratio, reduce errors, and ensure the accurate and timely processing of COB claims.<\/p><p><strong>Tired of COB complexities? Unlock efficiency with SymKey and bid farewell to payment headaches!<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-04a8c27 elementor-widget elementor-widget-spacer\" data-id=\"04a8c27\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e045acd elementor-widget elementor-widget-spacer\" data-id=\"e045acd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>The COB Challenge Coordination of Benefits (COB) \u2013 the perpetual headache for healthcare payers. Manual processes, incomplete member questionnaires, and the eternal struggle of determining the order of benefits. The result? Delayed payments, increase in appeals such as over payment and under payment of claims, and an increase of claim pend ratio. System Limitations Many [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":22224,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[101,102,57,30],"class_list":["post-22196","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthcare-information-management","tag-claims-processing","tag-coordination-of-benefits","tag-hcim","tag-symkey"],"_links":{"self":[{"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/posts\/22196","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\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/comments?post=22196"}],"version-history":[{"count":10,"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/posts\/22196\/revisions"}],"predecessor-version":[{"id":22230,"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/posts\/22196\/revisions\/22230"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/media\/22224"}],"wp:attachment":[{"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/media?parent=22196"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/categories?post=22196"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.varshabi.com\/HCIM2\/wp-json\/wp\/v2\/tags?post=22196"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}