Corporate Blog

HCIM Hosts Internal Business Unit Meetings

Monday, January 23rd, 2012

In November 2011, HCIM held two internal business unit meetings to involve all HCIM Colleagues in goal setting, brainstorming, troubleshooting, and team building.

HCIM’s Product Solutions business unit met at HCIM’s offices in Concord, Calif. to discuss the future of HCIM’s product offerings, create their product development schedule for 2012, and collaborate on the functionality and design of SymKey 2.5.

HCIM’s Professional Solutions business unit met in Nashville, Tenn. to discuss upcoming payer consulting configuration, implementation and ICD-10 projects, review current project successes and challenges, and to further define HCIM’s exclusive implementation and configuration toolset.

Future HCIM Business Unit Meetings will also include skill advancement training sessions and industry updates. HCIM is committed to hosting annual company-wide Business Unit Meetings in addition to its annual All Colleague Meeting (ACM). These collaborative meetings are part of HCIM’s ongoing, long-term initiative to regularly engage all colleagues “in person.”

ICD-10 Webinar Series for QNXT Users

Thursday, January 5th, 2012

88 QNXT users enjoyed HCIM and AXIOM’s Oct./Nov. 2011 webinar series on “ICD-10’s Impact on Your Business,” which was offered exclusively to QNXT users as a result of HCIM’s sponsorship of the Q-Users Group.

Throughout the four-part series of one hour webinars, ICD-10 expert Peggy Honts gave a brief overview of the ICD-10 coding system, explained the differences between ICD-9 and ICD-10, demonstrated a code analysis example using real ICD-10 codes, explained the financial impacts ICD-10 may have on different business areas, the risk mitigation factors involved, implementation best practices and recommended next steps. She also delved into the impact ICD-10 will have on:

  • Network Management
  • Claim/Encounter Processing
  • Information Technology (IT)
  • Member/Patient Management
  • Medical Management
  • Monitoring Business Metrics
  • Customer Service
  • Project Management Impacts
  • Staff Training
  • Reporting
  • Vendor Management
  • Testing/Trading Partner Management

Free Webinar eKit

If you missed any of the webinars, you can view the recordings and presentations on HCIM’s QNXT Webinar eKit. You’ll also find valuable ICD-10 resources, including:

  • Mind Mapping Overview: View the different areas of your business that could be affected by the ICD-10 transition using HCIM and AXIOM’s ICD-10 Payer Mind Map.
  • Conduct a Preliminary Assessment: Determine if you’re on track for a timely implementation and prioritize upcoming tasks with the AHIMA ICD-10-CM/PCS Readiness Assessment and Prioritization Tool.
  • Develop a Comprehensive Project Plan: Leverage the ICD-10 implementation tasks and estimated completion times in NCHICA and WEDI’s free ICD-10 Timeline to help develop your own ICD-10 project plan.
  • Stay on Track: Gauge your progress on both the ICD-10 and HIPAA EDI standards implementations with NCHICA and WEDI’s 5010 and ICD-10 Timeline Benchmarks.
  • Code Converter: Convert between ICD-9-CM and ICD-10-CM diagnosis codes and access a comprehensive code index using this free website.

More Information

To schedule a private webinar session for your company, email us at education@hcim.com or call 888-454-0202, option 5.

Sign up for an ICD-10 Assessment >>

About the CMS HIPAA 5010 Compliance Grace Period

Thursday, December 15th, 2011

CMS announced a 90-day grace period for HIPAA 5010 compliance on Nov. 17, 2011. While CMS did not offer a deadline extension on the HIPAA 5010 compliance date of January 1, 2012, they will not “initiate enforcement action” before March 31, 2012. What does this mean?

It’s certainly not a free pass, but it does offer leniency on full compliance until March 31, 2012. During the grace period, CMS’ Office of E-Health Standards and Services (OESS) will continue to accept complaints regarding non-compliance for Version 5010, NCPDP D.0, and NCPDP 3.0 transaction standards, but will not take enforcement action as long as the covered entities that complaints were filed against can “produce evidence of either compliance or a good faith effort to become compliant with the new HIPAA standards during the 90-day period.”

View CMS’ Full Statement About the 5010 90-Day Grace Period

View CMS’ 5010 Resources Page

PSW Seeing 3X ROI with SymKey for EZ-CAP

Thursday, September 29th, 2011

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 a small company like ours would be able to afford it, but the cost was so reasonable and the ROI was just amazing. I’m seeing a 3x return on my investment!”

Implementation

“The set-up and implementation was painless. When you said it would take three days to implement and move to production, I didn’t believe it. I was a project manager for large IT projects with the State of Washington and have never experienced such a seamless and short implementation. Instead of spending a week in training and weeks testing, we were live in three days.”

The Value of Automation

“We were initially only interested in the SymKey for EZ-CAP Professional Claims module because we had so many simple Professional claims to process that didn’t require the expertise of a claims processor. I knew that SymKey would save us a lot of time in manual work, and it did! But our Hospital claims were a different story – our custom interface tool passes data from EZ-CAP to our third-party MedAssets APC pricer and then exports the data to a spreadsheet so we can manually process each Hospital claim. I didn’t think that process could ever be automated, but it took HCIM only a couple hours to build a custom report for transferring data from the spreadsheet to SymKey for auto-pricing. This workaround saves a claims processor two days every week in Hospital claims adjudication, which allows for more time for other tasks. And since we were already licensing the Professional Claims module, the Hospital Claims module was half the price! I couldn’t believe the value.”

Minimizing Costs

“At our rate of growth, we’ve needed to hire more claims processors every year and I was actually down a claims processor when we started our SymKey trial, but our productivity has improved so much with SymKey that we don’t need to hire any new claims processors at this point. Because SymKey can handle all the claims we throw at it, we’re able to grow our business with a reduction in claims staff hiring.”

Operational Advantages

“Since we began using SymKey for EZ-CAP to process our Professional and Hospital claims, our turnaround time has improved noticeably. And SymKey’s a great tool for out of the ordinary claims processing projects. I’ve already used SymKey’s “Create Exact Claim Copy” scenario to reprice lists of claims at a line level – this saved a lot of time because many of the claims were multiple files and the manual process would have been very time consuming. SymKey also catches all our hard duplicate claims and pends them for review, which is fantastic.”

SymKey for Plexis Claims Manager Development Underway

Wednesday, September 28th, 2011

HCIM has begun the design and development of SymKey® for Plexis Claims Manager (PCM). HCIM has partnered with Plexis Healthcare Systems, a leading provider of core benefit administration and claims processing software, to cooperate on the development of this new product line. Together, the two companies have identified the initial workflows for SymKey to automate and will be working with one or more PCM client partners. General release is targeted for the end of 2011 and will contain many great new features.

Some of the key features of SymKey for PCM will be as follows:

  • Automation: Will provide SymKey’s proven advanced automation technology to adjudicate and enter additional information for PCM’s professional and institutional claims modules.
  • Source Data: Will utilize an input file structure similar to HCIM’s SymKey 2.0 Batch Processing module.
  • Flexibility: Users will be able to set up a processing job at their own workstation and then submit them to a server queue for processing.
  • Scheduling: The server queue will push the jobs to one or more processing engines, which can be scheduled to work at night or other low usage times.
  • Queue Manager: Users can check on the status or outcome of jobs using a queue manager that will enable them to view, modify, and report on jobs.

“We’re excited about the direction of SymKey for PCM and are diligently working to create a solution that will offer the best value for Plexis’ clients,” said Michael Wilson, President & CEO of HCIM.

About Plexis Healthcare Systems, Inc.
Since 1996 Plexis benefits administration software has been automating medical claims‚ dental claims and vision claims processing for commercial and public healthcare organizations across the U.S. and in several other countries. Plexis Healthcare Systems was founded in 1996 by healthcare IS consultant Jorge Yant, who recognized the difference a truly flexible, cost-reducing claims processing software could make for small and medium-size healthcare organizations. By partnering with clients, Plexis developed benefits administration software products to solve real-world needs, improve claims processing productivity, deliver a swift ROI, and help healthcare organizations expand their market share. Today, Plexis serves more than 80 healthcare payer organizations across the United States as well as international clients.

Boost the Speed of EZ-CAP 6.x for Maximum SymKey 2.0 Efficiency

Wednesday, September 28th, 2011

SymKey 2.0 for EZ-CAP 6.x has been available since February 2011 and is now available for all versions of EZ-CAP 6.x through 6.2.1. HCIM is continuing to develop and test solutions to new EZ-CAP 6.x versions as they are released.

While working with several EZ-CAP 6.x clients, some who are in production and others in test, HCIM Technical Development diligently explored every method to optimize the speed of EZ-CAP 6.x and of SymKey itself.  One of the major efforts was verifying SymKey functionality in the Windows 7 operating system. Efforts were focused on the 64-bit version of Windows 7, since this operating system can take full advantage of the full power of 64-bit hardware, newer processors, and RAM above 2 GB. Through this effort and testing SymKey at multiple sites, it was found that on a multi-processor PC with Windows 7 64-bit and 8GB of RAM, SymKey’s processing speed was 2-4 times faster than on a comparable Windows XP PC.

After such great results, the SymKey system requirements were changed in August 2011, to specify Windows 7 64-bit as the recommended operating system and SymKey 2.0 for EZ-CAP 6.x was certified for Windows 7 64-bit.

SymKey 2.0 users who are currently set up with a Windows XP or Windows 2003 Server workstation/virtual server for SymKey are strongly encouraged to upgrade to Windows 7 64-bit.  SymKey 1.31 for EZ-CAP 5.3 users who anticipate upgrading to EZ-CAP 6.x should contact HCIM for the latest SymKey 2.0 system requirements.   For system requirement information or for any questions regarding SymKey 2.0, please contact HCIM Product Support at support@hcim.com or call (888) 454-0202, option 2.

ICD-10 Webinar Series for QNXT Users Begins Oct. 3, 2011

Tuesday, September 27th, 2011

HCIM and AXIOM Systems have teamed up to provide QNXT users with the knowledge they need to navigate the complexities of the transition to the ICD-10 coding system.

This free educational webinar series will include four 1-hour webinars, with your choice of session on either Monday or Wednesday to better fit your schedule. Featured speaker and leading ICD-10 expert Peggy Honts of AXIOM Systems gives a brief overview of ICD-10, demonstrates real code analysis, explains one-to-many mapping, explores the financial impacts you can expect to see in different areas of your business, and provides implementation strategies that will help ensure a successful transition to ICD-10.

BONUS: Following the webinar series, participants will receive an eKit, including HCIM and AXIOM’s Mind Mapping Tool used during the four webinars, a copy of the webinar presentations, recordings from each of the four webinars, and links to valuable implementation/project plan resources.

Webinar One

Beginning with a brief overview of the ICD-10 coding system, learn the differences between ICD-9 and ICD-10, observe a code analysis example using real ICD-10 codes, and discuss the financial impacts ICD-10 will have on your business, including risk mitigation factors. AXIOM will help uncover the different areas of your business that will be affected. We’ll close with a Q&A session.
Option 1: Monday, Oct. 3, 2011 • 1 p.m. PT
Option 2: Wednesday, Oct. 5, 2011 • 11 a.m. PT

Webinar Two

Explore the impact ICD-10 will have on Network Management, including Provider Contracts, Physician Profiles, Provider Outreach, Reimbursement Methodologies, P4P, and more. Then we’ll look at Claim/Encounter Processing, Information Technology (IT), and Member/Patient Management. We’ll close with a Q&A session.
Option 1: Monday, Oct. 17, 2011 • 1 p.m. PT
Option 2: Wednesday, Oct. 19, 2011 • 11 a.m. PT

Webinar Three

Learn how ICD-10 will affect Medical Management, including Clinical Documentation, Care Plans, Disease/Population Management, Risk Assessments, and more. Then we’ll delve into Monitoring Business Metrics and Customer Service. We’ll conclude with a Q&A session.
Option 1: Monday, Oct. 24, 2011 • 1 p.m. PT
Option 2: Wednesday, Oct. 26, 2011 • 11 a.m. PT

Webinar Four

Learn how to make the ICD-10 implementation as painless as possible. We’ll look at Project Management Impacts, Staff Training, Testing, Data Strategies, Reporting Impacts, Vendor Management, and Testing/Trading Partner Management. We’ll end with implementation best practices and discuss your implementation next steps.
Option 1: Monday, Oct. 31, 2011 • 1 p.m. PT
Option 2: Wednesday, Nov. 2, 2011 • 11 a.m. PT

Register for this webinar series.

Note: You will automatically be registered for the entire webinar series and will therefore have the option of attending either the Monday or Wednesday session each week.

Your confirmation email will include instructions on logging in and a link to add the webinars to your Outlook calendar. Email education@hcim.com with any questions or concerns.

HCIM Welcomes QNXT Consultant, Bryan Richardson, to the Professional Solutions Team

Tuesday, September 27th, 2011

As a former HCIM consultant that was subsequently hired on by a large client, HCIM is pleased to welcome Bryan Richardson back to the Professional Solutions Team. Bryan has almost a decade of experience on QNXT, both as a consultant and as a QCSI/TriZetto client, and his formal education includes a BA from the University of Florida and an MBA from Rollins College. Bryan’s background includes six years of business process reengineering experience. He has completed six end-to-end implementations and several other smaller engagements. With his diversified background, Bryan has done everything from QNXT system implementations to service packs to version upgrades and bug fixes, and he can provide business requirement documentation, configuration, training and testing. In addition, Bryan has served as director of the configuration department of a Medicare Advantage plan and contracted with Medicare, Medicaid and Commercial plans as clients.

Bryan currently resides in the state of Florida and loves spending time on the water. “I’m excited to be a part of HCIM because they approach consulting in the right way. They are not just billing experts – they always return value for their clients. I was a client of HCIM for years, and I always appreciated the support and the honesty which accompanied their engagements. They are not afraid to stand behind their word, and they back it up not only in writing but also in their actions. That difference brought me here because I believe in the same values and share the same work ethic. I want to be the best and to be a part of the best,” said Bryan.

Bryan is joining HCIM as a Client Services Professional Consultant and will be working under the direction of Jeffrey Hall, Executive Vice President of Professional Solutions. “Bryan’s healthcare payer operations experience at a large health plan has provided him with valuable insight and a working knowledge of claims processing, adjudication efficiencies, QNXT best practices configuration solutions, and healthcare payer operations and management. His judicious approach to overcoming configuration and operational challenges, his strong work ethic and a common sense communication style makes him one of the most sought after QNXT experts in the industry. HCIM and our clients have already benefited from Bryan’s ‘can do’ attitude. We are pleased to have him on our team,” said Jeff.

HCIM Welcomes Tyra Dennis to the Professional Solutions Team

Wednesday, September 14th, 2011

HCIM welcomes Tyra Dennis to the Professional Solutions Team. Tyra brings with her nearly 20 years of healthcare administrative and operations experience. During this tenure, she has spent several years working as a Network Representative, Benefit Designer, Compliance Auditor, and as a Team Lead and Trainer for QNXT administration, ECIS, Medical Manager and Vision.

“I am excited to have the opportunity to work with one of the industry’s leading consulting companies, which is recognized for its dedication to its clients and colleagues. I look forward to using my knowledge and experience in working with payer systems administration to provide the best possible service and guidance to HCIM’s clients. Payer system analysis, design and configuration can be very complicated; however, my goal, with support from HCIM’s Professional Solutions Team, is to simplify them for our clients,” said Tyra.

Tyra currently resides in Indianapolis, Indiana, and her hobbies include sketching, interior design, and reading. She also enjoys adding to her collection of fine writing instruments and crystal.

Tyra is joining HCIM as a Client Services Professional Consultant and will be working under the direction of Jeffrey Hall, Executive Vice President of Professional Solutions. “Tyra’s practical healthcare operational experience is a valued commodity in our industry. She is able to bring her proven healthcare knowledge, experience and best practices configuration solutions to any project. I am pleased that she chose to join the ever growing ‘family of colleagues’ at HCIM,” said Jeff.

Free ICD-10 Educational Webinar Series Hits Home

Thursday, September 8th, 2011

Over 130 EZ-CAP users registered to attend HCIM and AXIOM Systems’ joint ICD-10 Educational Webinar Series, entitled “ICD-10’s Impact on Your Business.” Word traveled fast after MZI Healthcare encouraged its EZ-CAP client base to attend the free series via their EZ-Communicator email notice.

Featured speaker and leading ICD-10 and 5010 subject matter expert Peggy Honts of AXIOM Systems presented on ICD-10’s projected impact on key areas of a healthcare payer organization’s business and concluded the series with some helpful ICD-10 implementation strategies. Attendees appreciated the ICD-10 code analysis, real-life examples, and insight into impacted business areas that are often overlooked. HCIM received great feedback from this Summer 2011 series.

If you missed the webinar, you can view the ICD-10 Webinar eKit for a copy of the Mind Mapping Tool PDF, a 5010 and ICD-10 Benchmarks Timeline, a sample WEDI ICD-10 Timeline to help with your project plan, a free code converter, an exclusive special offer for an ICD-10 Impact Assessment, recordings from the four webinars, PDFs of all the session presentations, and more.

Below are the webinar polling results.

Which of the following business areas would you like to discuss throughout this webinar series?
90% – Reporting Impacts
80% – Claim/Encounter Processing
62% – Information Technology (IT)
56% – Vendor Management
52% – Disease/Population Management
40% – Monitoring Business Metrics
38% – Member Management
30% – Customer Service
28% – Testing/Trading Partner Management

What do you think will be your biggest hurdle with ICD-10?
33% – Resources (skills required for ICD-10)
33% – Staff Training
25% – Vendor Readiness
08% – Budget/Competing Priorities
00% – Executive Management Commitment

What is the sense of urgency around ICD-10 in your organization?
50% – On the radar, work is just beginning
20% – Aware, but no action yet
20% – Somewhat urgent
10% – Very urgent
00% – No urgency at all

How complete is your impact assessment?
27% – Not started yet
35% – 1-25% complete
24% – 26-50% complete
08% – 51-75% complete
05% – 76-100% complete

If you have any questions or would like to discuss your ICD-10 implementation, please email info@hcim.com or call 888-454-0202, option 5.