HCIM

Answer: One of SymKey’s global settings allows users to configure whether or not to zero out the contract value when SymKey denies a line in either the Professional or Hospital Claims modules. In SymKey v. 1.20 and later, the configuration of this action is reserved for users with an Admin security level.

To change the setting, click the “Global Settings” link in the “Configuration” section on the left side of the SymKey main menu. Once the “Global Settings” window opens, either check or uncheck the “Zero-out Contract Value when denying a line” checkbox, according to your organization’s business rules.

If you do not have sufficient rights to access SymKey’s Configuration section, please see your administrator or contact HCIM Product Support at support@hcim.com or 888-454-0202, option 2.

Answer: SymKey^® allows users to configure the handling of claims with COB (Coordination of Benefits). When EZ-CAP^® determines that a member has other coverage, it flags that claim as COB. SymKey can be configured to either pend COB claims for review if the coverage is Primary, pend for review when there is any other coverage, or ignore COB flags. In order to configure or change COB checking in SymKey 1.31 or later, users must have Admin level security rights.

Global COB Checking Configuration
On the left side of the SymKey main menu, click the “Global Settings” link in the “Configuration” section. From the “Global Settings” configuration window, either check the “Check Coordination of Benefits (COB)” checkbox to pend claims that EZ-CAP identified as COB or uncheck the checkbox to ignore all COB flags that SymKey encounters. You can also select the options below that checkbox to “Pend claim if COB and member has other Primary coverage” or “Pend claim if COB and member has any other coverage.”

Batch Level COB Checking Configuration
When “Check Coordination of Benefits (COB)” is enabled in SymKey’s Global Settings, users can still ignore COB pending at a batch level within SymKey’s Professional, Hospital, and Batch Processing modules. When configuring a Professional or Hospital Claims batch, simply check the “Ignore Pending for COB” checkbox in the “Global Options” section of the module. In the Batch Processing module, check the “Ignore Pending for COB” checkbox to the right of the “Source Claim Status” section. When “Ignore Pending for COB” is selected, SymKey will ignore the configured global setting to pend claims with COB for that batch only. Once the “Ignore Pending for COB” checkbox is unchecked or the SymKey claims processing module is closed, SymKey will no longer ignore the globally configured COB Checking setting.

Answer: In SymKey^® v. 1.31 and later, only Admin level users have sufficient security rights to configure or change how SymKey responds to EZ-CAP^® system error/warning messages. From the SymKey main menu, click the “EZ-CAP Messages” link under the Configuration section. This will open a window that shows every message that SymKey has encountered while running EZ-CAP. There are three sections in the window:

The Title section shows which EZ-CAP subsystem generated the message.
The Message section displays the specific EZ-CAP error or warning.
The Action section is a drop-down menu that displays how SymKey will respond to receiving that message and is the only editable area of the window.

If you would like to change the Action for a given message, click the drop-down arrow next to the appropriate action and select one of the two options: Pend or Ignore. When you are finished with your changes, simply close the window.

Answer: In SymKey^® v. 1.30 and above, the Users link is under the Configuration section on the left side of the Main Menu. The rights to add/change SymKey users is limited to the Admin security role. If the Users link is enabled, then you have sufficient rights to make these changes. Selecting the Users link from the Main Menu will take you to the Users configuration screen. From here, you can add a new user, delete an existing user, or reset a user’s password.

To add a new user, click the “New User” button, enter a User ID, choose an appropriate security role, enter the password in the next two fields, and then click the “Save New User” button to add the new user to the list. To delete a user, highlight the user to be removed from SymKey and then click the “Delete User” button. You will be asked to confirm your deletion. To reset a password, highlight the user in the list and then click the “Reset Password” button. You will be asked to enter a new password for the user.