Healthcare Executives Use AI to Reduce Administrative Burden

According to the following MCOL infographic, 23% of the healthcare executives that were surveyed stated that the greatest opportunity provided by Artificial Intelligence (AI) is that it reduces their administrative burden. SymKey® clients have been using AI to automate their healthcare claims processing since 2002. Robotic Process Automation (RPA) allows payers to process more claims […]

Never Stop Innovating: Using AI in Your Claim Process

Never Stop Innovating: Using AI in Your Claim Process

If your claims process hasn’t changed in years, it may be time for an upgrade. From your auto-adjudication rate to your claims turnaround times and everything in between, there’s always room for improvement. Claim quality is integral to your bottom line and to maintaining provider satisfaction. HCIM is a pioneer in claims artificial intelligence. As […]

Clients Love Using SymKey to Increase their Auto-Adjudication

Clients Love Using SymKey to Increase their Auto-Adjudication

We all know that SymKey® users love how their robotic claims automation tool increases their productivity, improves turnaround times, and reduces errors.  We firmly believe that no claims department should be without SymKey®. But when’s the last time you bought something without reading customer reviews? Listen to what our clients have to say: “SymKey’s an asset to […]

2017 is the Year of the Bot!

2017 is the Year of the Bot!

There’s a strong movement in the corporate world to leverage artificial intelligence and automate workflow decisions. This strategy increases accuracy and lowers the cost of operations, which in turn frees up these companies to further innovate. With the overwhelming pressure for organizations to streamline and be more efficient, robotic process automation will emerge as the […]

HCIM Recognized by CIOReview as one of the 20 Most Promising Productivity Solution Providers in 2016

HCIM Recognized by CIOReview as one of the 20 Most Promising Productivity Solution Providers in 2016

HealthCare Information Management, Inc. (HCIM) announced today that it has been named one of CIOReview’s 20 Most Promising Productivity Solution Providers for 2016. This honor was bestowed to only 20 organizations across all industries in the United States. “Applying innovation and technological expertise, HCIM has developed robotic claims automation solutions that augment their clients’ existing […]

Increase Office Productivity with Robotic Process Automation

Increase Office Productivity with Robotic Process Automation

People get downright passionate about their favorite productivity hacks because they make life so much more enjoyable, so let me introduce you to mine. You probably already use business software, whether it be Outlook, Exchange, Salesforce, or GoToMeeting. And once they become a part of your daily routine, you couldn’t imagine life without them, right? […]

Client Spotlight on Northwest Physicians Network

Client Spotlight on Northwest Physicians Network

During a year of rapid growth, Northwest Physicians Network (NPN) doubled the size of their Provider network and drastically increased their membership. With plans to take on one or two more health plans next year, they decided to get ahead of the additional workload by licensing SymKey® to increase their claims auto-adjudication rate through robotic […]

SymKey® Wins Most Valuable Processor for Second Year Running

SymKey® Wins Most Valuable Processor for Second Year Running

The SymKey® claims processing stats for 2015 are in and they’re unbelievable. We compiled statistics from 80% of our clients, covering a combined total of over 2.5 million lives. Across these clients, SymKey® touched 7.8 million claims with 5.25 million approved/denied for a 67% completion rate. This represents FTE savings of approximately 264 claims examiners, or […]

Reprocessing Previously Paid Historical Claims can be a Piece of Cake!

Reprocessing Previously Paid Historical Claims can be a Piece of Cake!

Oftentimes claims staff put off the dreaded task of manually reprocessing previously paid claims because it can be difficult and time-consuming. Do you ever run into any of the following problems? CMS makes corrections to the Medicare Physician Fee Schedule (MPFS) and you must retroactively reprocess Medicare fee-for-service claims Members are identified as retroactively termed after the claims were […]

Get a Quick and Easy Productivity Boost with Kwik Actions™

Get a Quick and Easy Productivity Boost with Kwik Actions™

Kwik Actions™ is a scaled-down version of SymKey® for Claims that increases the efficiency and productivity of claims operations staff by automating routine tasks. Kwik Actions™ are customized “hotkeys” that users may utilize on demand to perform a predetermined set of screen navigation actions such as keystrokes, mouse clicks, database queries, and interfacing between multiple […]

Back to the Future has Nothing on SymKey<sup>®</sup> Robots!

Back to the Future has Nothing on SymKey® Robots!

2015 came and went, but unfortunately many of the Back to the Future II predictions for life in 2015 have not come to fruition. No self-drying clothes or flying cars. We still have to pump our own gas and locate the closest waste receptacle because robots have not been invented to perform those tasks yet. […]

CIOReview Selects HCIM as 2015’s 50 Most Promising Healthcare Tech Solution Providers

CIOReview Selects HCIM as 2015’s 50 Most Promising Healthcare Tech Solution Providers

HCIM was honored as one of 2015’s Top 50 Most Promising Healthcare Tech Solution Providers for its cost-effective and flexible technology solutions for healthcare payers and managed care organizations HealthCare Information Management, Inc. (HCIM) was selected as one of the nation’s 50 Most Promising Healthcare Tech Solution Providers by CIOReview, based on HCIM’s innovative automation […]

Heritage Provider Network Leverages SymKey® Enterprise License

Heritage Provider Network (HPN) is utilizing a SymKey® Enterprise License for all seven of their sites which includes the use of all SymKey® modules (Professional, Hospital, Virtual Auto-Post™) and unlimited processing engines for increased productivity. “We’re looking for whatever we can do to automate our business processes accurately and without errors. The less we can […]

New Virtual Examiner<sup>®</sup> and Claims Audit Tool<sup>™</sup> Solution Suite Featuring SymKey<sup>®</sup> Automation

New Virtual Examiner® and Claims Audit Tool Solution Suite Featuring SymKey® Automation

This past July, a large Medicaid health plan licensed the Virtual Examiner® (VE) and Claims Audit Tool™ (CAT) solution featuring SymKey® Virtual Auto-Post™ (VAP) automation for the QNXT™ claims system. This cost-effective integrated solution will help the client to realize potentially millions of dollars in overpayment and rework savings, and generate significant ROI. It will […]

Innovative Post-Payment SymKey® Uses

Innovative Post-Payment SymKey® Uses

HCIM’s SymKey® clients are able to automate the post-payment reprocessing of claims in order to handle large volumes of claims without the need to hire additional claims staff. Some of these post-payment uses include: Applying CMS retroactive fee schedule changes Applying retroactive Provider contract fee schedule changes Identifying/correcting ineligible Providers/Vendors for services Correcting member eligibility […]

SymKey Wins 2014 Most Valuable Processor (MVP)

SymKey Wins 2014 Most Valuable Processor (MVP)

HCIM’s flagship SymKey® business process automation solution has had another banner year of processing professional and hospital claims. To see what kind of impact SymKey® had in 2014, we compiled statistics in a limited survey of 18 of our SymKey® clients. We found that for these clients alone in 2014, SymKey® achieved a return on investment […]

SymKey’s Reprocess/Pend scenario is a perfect automated solution for adjusting paid EZ-CAP claims 6-10x faster than manually

The SymKey® Reprocess/Pend scenario (available via a query or TXT file) reprocesses EZ-CAP® status 9 paid claims by duplicating the claim and all detail lines, adjusting the original net pay of each line, re-pricing each claim line, adding a Processing Status note to reference the original claim, and then pending the duplicated claim to status […]

Tuality Health Alliance Leverages Integrated Suite of Automated Solutions

Tuality Health Alliance (Tuality) is a physician-hospital community organization that contracts with over a dozen health plans. Their physician membership includes approximately 80 primary-care physicians and 200 specialists. Tuality went live with SymKey® for Plexis Claims Manager™ in mid-July, 2014. Within the first month, they were processing an average of 400 claims per hour with […]

CIOReview Selects HCIM as 2014’s 20 Most Promising Healthcare Consulting Providers

CIOReview Selects HCIM as 2014’s 20 Most Promising Healthcare Consulting Providers

HCIM honored as one of 2014’s Top 20 Most Promising Healthcare Consulting Providers by CIOReview, for its expertise in delivering technology solutions and consulting services to healthcare payers and managed care organizations HealthCare Information Management, Inc. (HCIM) was selected out of over 400 companies as one of the nation’s 20 Most Promising Healthcare Consulting Providers […]

HCIM and PCG Software Announce Partnership to Reduce the Cost of Healthcare for Payers and Other Managed Care Organizations

HCIM to Serve as the Exclusive Value-Added Reseller for PCG Software’s Virtual Examiner® and Virtual Reporter® HCIM and PCG Software, Inc. (PCG) today announced an exclusive value-added reseller (VAR) agreement to resell PCG’s Virtual Examiner® and Virtual Reporter® (VE/VR) claims recommendation software to the healthcare payer/managed care industry. With the use of more than 30 […]

Heritage Provider Network Secures SymKey® Enterprise License

HCIM is pleased to announce that Heritage Provider Network (HPN) is the first EZ-CAP® client to sign a SymKey® Enterprise license. Their Enterprise level agreement includes access to the entire SymKey® for EZ-CAP® suite of solutions, including the Professional, Hospital, and Virtual Auto-Post™ modules for all seven of HPN’s sites. As an added bonus, HPN […]

New HCIM Customer Portal and Ticketing System

In order to provide our clients with the best possible customer service, HCIM has launched a new ticketing system on the TeamSupport platform. The new HCIM Customer Portal allows clients to submit tickets via a web form, track updates, access support documentation, and search the knowledgebase. When clients submit a ticket via the Customer Portal, […]

Tips & Tricks: SymKey’s “set it and forget it” functionality

SymKey’s enhanced user interface and innovative features including the Query Builder, Query Sequencer, and Scheduler, have greatly improved our clients’ productivity. HCIM’s clients rave about the “set it and forget it” functionality that allows them to run SymKey® unattended. The Query feature allows the building of any type of SQL-language report directly within SymKey®, for […]

Tips & Tricks: Copy and Reverse

Did you know that SymKey® can accurately copy and/or reverse a claim, with or without repricing the contract values in the claim detail lines? Create Exact Claim Copy Functionality Use this action to split claims with a DOS that spans a benefit or contract renewal date, or to divide financial responsibility. With the Exact Claim […]

State of the Payor Industry Survey Indicates Need for Business Process Automation

More than 130 leaders from health plans across the United States responded to HealthEdge’s Jan. 2014 “State of the Payor” industry survey. As a company that offers business process automation solutions, we were particularly interested in question #4 (below), which shows that 81.3% of surveyed payors believe it would significantly reduce their administrative costs to […]

New SymKey® 3.0 Functionality: “Add a Line” Scenarios

Do you often need to add a detail line to your claims? If your claims processors are manually performing the following tasks over and over again, it’s time to automate them! SymKey® can add a claim line for: Bundling codes together in a new line to approve or deny Down-coding a level 5 ER visit […]

Do you manually apply the 2% Medicare Sequestration?

The Budget Control Act of 2011 required mandatory, across the board reductions in federal spending, which has been more commonly referred to as sequestration. CMS Announces FFS Payment Reductions – March 8, 2013 Due to the sequestration, CMS announced mandatory 2% payment reductions in the Medicare Fee-for-Service (Part A and Part B) Program and would […]

Organize, modify, and auto-load your benefit plans into QNXT™

HCIM’s SymKey® Benefit Plan Loader tool for QNXT™ allows you to update your benefit plan data 6-8x faster! Seamlessly integrates with your QNXT™ claim system and extracts your benefit plans directly into validated spreadsheet templates Stores all your benefit plan data in a centralized location for easy updates Provides accurate and consistent auto-loading of benefit […]

Client Spotlight: Network Medical Management

Network Medical Management (NMM), an MSO overseeing eight IPAs in seven Southern California counties, licensed SymKey 3.0 for EZ-CAP in June 2013. They have been using SymKey to automate their claims processing at speeds averaging over 700 claims per hour. During their 30-day trial, SymKey processed 15,000 claims in 24 hours! “During NMM’s 30-day trial, […]

Can’t find your authorization? Let SymKey do it.

SymKey 3.0 can identify the corresponding Auth IDs for professional claims, automatically populate the authorization, and then reprice all claim lines. As an added bonus, SymKey is able to run unattended around the clock, at speeds averaging over 700 claims per hour. Talk about time savings! And SymKey works within your existing core claims transaction […]

EZ-CAP Clients Process 749 Claims per Hour with SymKey Automation

The 2012 SymKey® for EZ-CAP® Productivity Stats are in and five of our clients are averaging over 1,000 claims per hour (CPH)! Overall, HCIM’s SymKey for EZ-CAP clients averaged 749 claims per hour last year. Now that’s smoking fast! Take a look at the 2012 SymKey for EZ-CAP productivity stats below. Highlighted Stats Overall Averaged 2012 SymKey […]

5 SymKey Clients Exceed 1,000 CPH in 2012!

The 2012 SymKey for EZ-CAP productivity stats are in and five of our clients are averaging over 1,000 claims per hour (CPH)! The average claims processing speed is 749 claims per hour and one of our clients is processing an unprecedented 3,000+ claims per hour. HCIM’s SymKey for EZ-CAP application is specifically designed to automate […]

Client Spotlight: PrimaryHealth of Josephine County

Following a successful 30-day trial period, PrimaryHealth of Josephine County (PHJC), formerly Oregon Health Management Services, licensed SymKey 2.0 for EZ-CAP 6.x on Oct. 20, 2012. “We decided to begin a free 30-day SymKey trial to see if it could speed up our adjudication process by auto-adjudicating more claims. When Greg and Tom came on […]

Spotlight on Choice Medical Group

Choice Medical Group signed a 3-year license for the SymKey® 1.31 for EZ-CAP® 5.x Professional Claims module and Virtual Auto-Post™ module in July 2012. Choice originally decided to pursue HCIM’s 30-day risk-free SymKey trial in June 2012 to see if it could help them to auto-adjudicate Professional claims and reduce their manual processes. They decided […]

SymKey 3.0 for EZ-CAP Functionality

SymKey® 3.0 for EZ-CAP® versions 5.x and 6.x is now available and includes a new user interface with a Batch Manager, Listener, Scheduler, and Query Builder functionality. HCIM will demonstrate the SymKey 3.0 for EZ-CAP application at the Oct. 4-5, 2012 EZ-CAP WRUG Conference in Huntington Beach, Calif. The new Batch Manager allows users to […]

2011 SymKey for EZ-CAP Client Productivity Stats

HCIM’s SymKey® for EZ-CAP® application is specifically designed to automate the processing of claims within the EZ-CAP® claims transaction system. Using programmed artificial intelligence and innovative keystroke emulation technology, SymKey can help claims staff to process claims up to 40 times faster. Some of HCIM’s SymKey clients have been able to process over 1,000 claims […]

SymKey for Plexis Claims Manager

SymKey for Plexis Claims Manager (PCM) was released on May 1, 2012, and will be demonstrated via webinar in August 2012 and at the upcoming Plexis 2012 User Conference, Sept. 9-12. Ashland, Oregon-based Plexis Healthcare Systems (Plexis) has partnered with HCIM to identify potential SymKey for PCM pilot sites. Together, HCIM and Plexis surveyed a […]

SymKey for QNXT Benefit and Contract Loader Utilities

A recent Q-User’s Group (QUG) email about Provider Contract setup forms sparked interest in HCIM’s automated Benefit Plan and Provider Contract Loader utilities. These utilities seamlessly interact with the QNXT user interface to build benefits/contracts using a spreadsheet template and SymKey’s advanced automation engine, eliminating manual entry for the consistent and accurate loading of benefits […]

Spotlight on Desert Oasis Healthcare (DOHC)

After a successful 30-day risk-free trial, Desert Oasis Healthcare (DOHC), a subsidiary of Heritage Provider Network, Inc., licensed the SymKey® 2.0 for EZ-CAP® 6.x Virtual Auto-Post™ (VAP) module on May 1, 2012. VAP automates the posting of PCG Software Inc.’s Virtual Examiner®/Reporter® (VE/VR) claims recommendations into the EZ-CAP® system. “We were looking to increase examiner […]

PSW Seeing 3X ROI with SymKey for EZ-CAP

Olympia-based Physicians of Southwest Washington (PSW) licensed the SymKey® for EZ-CAP® Professional and Hospital Claims modules for a three-year licensing period in August 2011, after a successful 30-day Risk Free Trial. Here’s what Tamra Ruymann, Claims Manager at PSW has to say about SymKey: Return on Investment “SymKey’s price tag was unbelievable! I didn’t think […]

SymKey Saves the Day at NAMM-IL

The Problem 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 […]

FAQ: The 2010 CMS Fee Schedule was released and is effective retroactively. We have already paid claims for the last several months that now need to be repriced. Can SymKey automatically reprice them?

Yes, SymKey’s “Reprocess/Pend” standard scenario is a perfect automated solution for repricing paid claims and is very simple to use for EZ-CAP status 9 claims. Create a .txt file with a list of the paid claim numbers that need to be repriced Open the SymKey Professional Claims module Check the “Reprocess/Pend” checkbox about ¾ the […]

FAQ: How can we expand our use of SymKey to handle more claims?

Answer: This is a four-step process: Identify the type of claims that you would like to target (i.e. denying claims that exceed a timely filing threshold). Define what claims fall into this scenario (i.e. timely filing claims may be in-network providers as defined by the “ZZZ” in the Provider Contract field, where the date received […]

FAQ: Can SymKey move claims within EZ-CAP to a status beyond 3?

Answer: SymKey for EZ-CAP is designed to work within EZ-CAP’s Professional and Hospital claims modules. As a result, it is able to automate the moving of claims that are in status 1-7 to a status 1 or 3. It can also reprocess status 9 claims by creating a new claim number, entering all related detail line information, and […]

Can BPA help you ditch the Sticky Notes?

During my time spent as an Operations Manager, I remember that my claims processors had sticky notes all over their monitors and cheat sheets that they would use to remind them of manual or special processes for certain providers or members. Not everyone had the same sticky notes, nor did they all have the same handwritten […]

01/25/2010: HCIM and DataWing Software Begin SymKey for EZ-CAP DataWing Auto-Post Module Co-Development Project

WALNUT CREEK, Calif. – Jan. 25, 2010 – HealthCare Information Management, Inc. (HCIM) and DataWing Software, an HCIM business affiliate, began work today on a collaborative effort to create a SymKey® for EZ-CAP® DataWing Auto-Post Module that will automatically post data from DataWing Software’s Eligibility Manager® and DataTug applications into EZ-CAP’s Eligibility module.

“Our products are […]