HCIM

Corporate Structure

Privately held by company founders and employees, financially self-sustaining and profitable since inception. Headquartered in Walnut Creek, Calif. with employees all over the United States.

Mission

HCIM will support all internal and external customers by providing quality products and services that are cost and time efficient. These enduring relationships are built on responsiveness, respect and awareness of each other’s needs. Our mission is to simply provide the best advice, products, services and support.

History

In July 2000, five managed care operations and information technology experts founded HCIM with the goal of addressing the complexities of the managed care payer industry with a combination of consulting services and automated software solutions.

Three of the original co-founders are still actively involved in the business, including: Michael E. Wilson, who brings a wealth of operational and industry system expertise to his role as President and CEO of HCIM; Jeffrey M. Hall, EVP, Client Services, who boasts a strong background in reporting services and managed care core claims system consulting; and Thomas J. Streeter, SVP and Director of Technical Development, who specializes in reporting and custom application development.

Hall became HCIM’s first full time employee in July 2000, when he secured a Consulting Services contract at John Muir Health/John Muir Physician Network in Walnut Creek, Calif. Streeter was added to the John Muir services contract the following month and Wilson became HCIM’s third full time employee in Sept. 2000.

Streeter was soon programming HCIM’s flagship product, SymKey, which is an advanced automation application for benefits administration systems that was originally conceptualized by Wilson. In January 2001, HCIM sold its SymKey for Pathways Managed Care application to Contract Management Organization (CMO), a subsidiary of Montefiore Medical Center. SymKey was subsequently migrated over to AMISYS Client Server and has since been developed for the EZ-CAP, Facets, and QNXT core managed care benefits administration systems in response to client requests.

In Aug. 2001, HCIM sold the ScanClaims product suite to one of its clients as an authorized reseller and ScanClaims Inc. business affiliate. HCIM soon saw the opportunity to grow the ScanClaims complete claims imaging, scanning workflow, and inventory management system as a complement to its own software solutions, and acquired ScanClaims Inc. and its founder, Gregory K. Merica, in Nov. 2003. Merica is currently HCIM’s Senior Product Integration Engineer.

In 2004, HCIM developed Appeals Manager as a custom application to allow a client to address the newly implemented California AB1455 legislation, and has since adapted the application for the general market.

Products

Appeals Manager™ – automated solution for provider appeals and resolutions
ScanClaims® – complete work-flow and inventory management solution
SymKey® – advanced automation application for benefits administration systems
     Hospital/Facility Claims – automated adjudication of hospital/facility claims
     Professional/Medical Claims – automated adjudication of professional/medical claims
     Utilization Management – automated adjudication of authorization requests
     Virtual Auto-Post™ – automated posting of Virtual Examiner® claims recommendations
     Kwik Actions™ – automated work navigation & productivity tool
     Kwik Utility™ – automated batch processing utilities

Services

HCIM’s Professional Consultants offer payer software application implementation services such as project planning, business rules configuration, conversions, custom software development, report development, operational/workflow assessments, testing, and interface/integration of third party applications. Click to learn more about HCIM’s products and services or call 888-454-0202, option 5.

Market

ASO, EPO, HMO, IPA, MSO, PHO, POS, PPO, TPA, Benefit Administrator, Healthcare Payer Organization, Managed Care Payer Organization, Health Benefits Trust, Health Plan, Health Trust, Medical Group, Medicare Advantage Health Plan, Federal and State Programs. Businesses that use managed care/healthcare payer benefit administration core claims transaction systems such as Amisys, El Dorado, EZ-CAP, Facets, HealthTrio, IDX, ikaClaims, ikaSystems, MC400, PLEXIS Claims Manager (PCM), PLEXIS Quantum Choice (QC), and QNXT.

Affiliates

AnyDoc Software, AnyWare Group, AXIOM Systems, Beth C Herold, Brigandine Solutions, DataWing Software, GW Operational Consulting Group, IBA Healthcare Consultants, Monument Systems, Plexis Healthcare Systems, The Jacobson Group, MZI HealthCare, PCG Software, RPM Solutions, The TriZetto® Group.

Partnerships

TriZetto® Certified Service Partner on the QNXT™ platform since 2004.
Official EZ-CAP® Partner since 2006.