Answer: In SymKey® v. 1.30 and later, click the “Hard Duplicates” link under the Modules section on the left side of the main menu. In the Hard Duplicates Generator window, you will see that the checkboxes for SymKey’s default configuration are preselected. By default, the Hard Duplicates Generator will match the following:
- Claims in status 1, 2, or 3 (Suspect Claims) received during the past month against claims received at any date that are in status 5, 6, or 9 (Target Claims)
- Only look at suspect claims where EZ-CAP has marked any line on the claim with a “DUP” flag in the P7 field
- Suspect claim matches target claim’s header info for:
- Member ID
- Vendor ID
- Every suspect claim line matches a unique line on the target claim by:
- Service Date From
- Service Type
- Service Code
- Billed Charge
You may further refine the matching criteria by checking the appropriate checkboxes. When you are ready to run the report, click the “Create File” button. SymKey will search for the duplicate claims that meet your criteria and begin building a batch file. Once completed, SymKey will save the new file under C:\SymKey\Files\Source by default. You can then run that duplicates file in the appropriate SymKey Professional or Hospital Claims module and deny them per your business rules. For more information, refer to your SymKey User Guide or contact HCIM Product Support at support@hcim.com or 888-454-0202, ext. 2.
