HCIM News - July 2011

An empowered business team.

Client News
	SymKey Saves the Day at NAMM-IL North American Medical Management of Illinois, Inc. (NAMM-IL) was recently impacted by a retroactive fee schedule change that involved processing over 300,000 claims on top of their current workload! A project of this magnitude threatened to bring their normal day-to-day operations to a standstill as staff would've had to pour thousands of hours into reprocessing the claims. here's what they did >> Arcadian Renews SymKey License Arcadian Management Services, Inc. renewed their SymKey for EZ-CAP license for another three years, through June, 2014. "SymKey has been a great product for our company, allowing us to auto-adjudicate a large volume of our claims with a high accuracy, with a big savings to our administration expenses; we are looking forward to continuing the relationship with HCIM for years to come," said Khaled Ghaly, Director of Claims at Arcadian. Community Health Center Network Community Health Center Network (CHCN) of San Leandro, Calif., began a 30-day trial for the SymKey for EZ-CAP Virtual Auto-Post and Professional Claims modules on July 8, 2011, after a successful 3-day on-site implementation and CHCN staff training. Physicians of Southwest Washington Physicians of Southwest Washington (PSW), based in Olympia, Wash., is scheduled to begin a 30-day SymKey for EZ-CAP trial the last week of July. HCIM SymKey implementation professionals will be on-site for three days that week to train PSW staff.
Product Solutions
	SymKey 2.0 for EZ-CAP v. 6.2 SymKey 2.0 is currently in production and supports all existing versions of EZ-CAP 6.x. HCIM is continuing to develop and test solutions to new EZ-CAP versions as they are released. SymKey for Plexis Claims Manager The initial design and development of SymKey for Plexis Claims Manager (PCM) is scheduled to begin in July 2011 as part of a joint effort between Plexis Healthcare Systems and HCIM. General release is targeted for the end of 2011. SymKey for EZ-CAP DataWing Auto-Post The new SymKey for EZ-CAP DataWing Auto-Post module automates manual eligibility updates for EZ-CAP using SymKey’s innovative keystroke emulation technology. fact sheet >> FileBound to be Integrated into ScanClaims HCIM is now a FileBound reseller and will integrate the browser based document management system into their ScanClaims product line. FileBound will help take HCIM’s Prior Authorization Workflow product line to the next level. Greg Merica, HCIM’s Director of Product Management Integration, completed FileBound training in February and is now a FileBound Certified Professional (FBCP). more >> Tom Streeter Completed AnyDoc Training In April, 2011, Tom Streeter, HCIM’s SVP, Product Solutions, attended a week-long accelerated AnyDoc class and completed his certification for OCR for AnyDoc Template Design and OCR for AnyDoc Batch Processing.
Professional Solutions
	HCIM's Performance Assurance™ Pledge HCIM has just raised the bar in healthcare payer consulting services with a groundbreaking Performance Assurance pledge. We pledge to deliver professional, competent, and affordable consulting services to the agreed-upon specifications or fix it at no additional charge. This means that clients will never be charged more than the price they were quoted for their project to be completed to specification. more >> HCIM Newest Q-Users Group Sponsor As the QNXT User Group’s newest sponsor and a TriZetto Certified Service Partner (CSP) for the QNXT product line, HCIM is committed to delivering valuable services and solutions to QNXT clients. HCIM made its debut as Q-Users Group sponsor at the 2011 Spring Q-Users Group Meeting in Orlando, Fla. on May 18. AllCare IPA Custom Aetna Eligibility Project HCIM was recently engaged by AllCare IPA in Modesto, Calif. to enhance AllCare’s custom eligibility application to work with Aetna’s new combined capitation/eligibility file layout. July is the first month that these enhancements are processing the new Aetna file.
Company News
	Houston, Hot Dogs, and Hold'em HCIM’s June 24-25 All Colleague Meeting (ACM) was held in Houston, Texas. Colleagues met to set the strategic direction of the company and were rewarded with Texas-style BBQ and a private suite at Minute Maid Park for the Houston Astros vs. Tampa Bay Rays baseball game. Marilyn Nickles took home the grand prize after winning Houston Hold’em with a four-of-a-kind. photos & more >> John Rickenbach Hired as Director of Technical Development >> Thomas Streeter Takes on New Role as SVP, Product Solutions >> Kimberly Magras Promoted to Administrative Services Coordinator >>

Recent Blog Entries
	ICD-10 Myth Buster: Do GEMs provide simple one-to-one Reimbursement Mappings? >> How to identify and deny duplicate claims in EZ-CAP >> Masks, Beads, and EZ-CAP >>

	HCIM and AXIOM Systems have teamed up to provide EZ-CAP users with the knowledge they need to navigate the complexities of the transition to the ICD-10 coding system. During July and August of 2011, we’re offering a free webinar series on “ICD-10's Impact on Your Business."
Testimonials
	When our fee schedules were recently updated for 2011, we were faced with the enormous task of recreating and repricing nearly 150,000 claims. Because we did not want to inflate claims utilization, we could not reprocess each detail line in a single step – pay new contract amount and adjust out the previously paid amount. For each claim to be reprocessed, a reversal and a positive claim were created. Thus, 150,000 claims became 300,000 claims! We worked with HCIM to develop scenarios for this process. Since we didn’t want to pay an item that was denied on the original claim, HCIM also helped develop a script to ensure that if a detail line was denied on the original claim, it was also denied on the repriced claim. Without SymKey’s help, completion of the project in a timely manner would have been near impossible. Now, if only SymKey could do the review and post the claims as well!" Bonnie Mezzano, Director of Claims at NAMM-IL
About HCIM
	Consulting Services HCIM’s industry-experienced consultants specialize in: • payer system configuration • system implementation • operational assessments • application development • historical data conversions • project planning • project management • staff training HCIM's consulting group has hands on experience and training on the latest technologies and leading healthcare payer core transaction systems, including: • QNXT™ • Facets® • EZ-CAP® • ikaSystems • DIAMOND®950 • AMISYS Advance™ HCIM’s predesigned approach and industry expertise save you time and money. more >> SymKey® HCIM's SymKey product suite maximizes the performance of your core benefits administration system through the automation of claims processing, authorization requests, and posting claims recommendations. more >> ScanClaims™ The ScanClaims product suite delivers unprecedented savings and productivity through state-of-the-art OCR scanning, imaging, data scrubbing, validation, and data management of claims and authorizations. more >> Appeals Manager™ The Appeals Manager application is a leading edge software product that offers an efficient and automated solution for addressing CA AB1455 Appeals and Provider Dispute Resolution (PDR) processes. more >>