HCIM

Product-Based Solutions

HCIM offers many innovative software solutions, including the SymKey®, ScanClaims®, and Appeals Manager™ product suites, which increase productivity by automating and tracking the adjudication of claims, authorizations, appeals, and provider dispute resolutions.

SymKey®	ScanClaims®	Appeals Manager™
SymKey utilizes advanced automation technology combined with programmed artificial intelligence to bring claims and authorizations processing to optimal levels of efficiency, both cost-effectively and quickly. SymKey bridges the functionality gaps found in many of the leading healthcare payer core transaction systems, which results in faster and more accurate claims/auths processing.	ScanClaims delivers unprecedented savings and productivity through state-of-the-art OCR scanning, imaging, data scrubbing, validation, and data management of claims and authorizations. ScanClaims improves data accuracy by applying advanced algorithms and business rules to member and provider data prior to importing claims and authorizations through HIPAA and standard EDI formats.	Appeals Manager is an automated solution for addressing CA AB 1455 Appeals and Provider Dispute Resolution processes, providing the efficient tracking of claims appeals, the automated generation of appeal letters for providers, a record history for auditing and tracking, reduced manual work in provider communications, and electronic routing to internal departments for review/approval.

 

Consulting Services

With an array of development, operational, implementation, and configuration services, HCIM provides the support and knowledge you need to enhance your business operations – positioning you for competition in an ever-evolving healthcare marketplace. With years of hands-on claims operations and business analysis experience, HCIM’s trained professional consultants understand that each client has a unique business structure and strive to ensure the required solutions meet your distinct business processes and exceed your expectations. You have our commitment that HCIM’s resources will never propose a “cookie cutter” solution.

Payer System Services	IT Development Services	Operational Consulting
System Implementation	IT Project Management	Business Analysis
Payer System Conversion	Database Analysis	Workflow Analysis
Payer System Configuration	Database Development	Organizational Review
Business Rules Configuration	Data Mart & ETL Analysis	Health Plan Audit Preparation
Comprehensive Testing Services	Custom Report Development	Training Program Development
Legacy Data Conversion	Custom Software Development	Business Intelligence & Analytics
Payer System Maintenance	Full Cycle Testing	Claims Processing Overflow
Interface/Integration of 3rd Party Applications	Interface/Integration of 3rd Party Applications	Documentation of Policies & Procedures