Determining the Success of the HITECH Act

Guest post by Definitive Healthcare After nearly seven years since the $35 billion HITECH Act was passed, some look at the slow pace of Meaningful Use, the relatively poor interoperability of EHR systems, and the physician workflow complaints and ask, “What has it actually accomplished?” A new study performed by Mathematica Policy Research and presented […]

Reining in Hospital Supply Costs and Physician Preference Item Spending

Guest post by Definitive Healthcare Supply costs are a primary target of healthcare organizations looking to optimize their operations. Unlike labor and overhead expenses, medical and surgical supply spending is more discretionary and has less immediate impact on clinical care or capacity. In addition, supplies are an increasingly large component of healthcare spending, with the […]

Is Comprehensive Community-Based Population Health the Future of Healthcare?

Guest post by Definitive Healthcare As hospitals have embraced value-based healthcare over the past several years, many observers have noticed that quality outcomes depend not only on medical treatment, but also on positive socioeconomic factors. A patient with stable housing and employment as well as access to healthy food is more likely to be in […]

Are Today’s Providers Overwhelmed by Quality Reporting?

Guest post by Definitive Healthcare In today’s healthcare delivery environment, few concerns are as important to providers, payers, and consumers as quality. Quality scores can drive patients towards or away from hospitals and doctors, determine reimbursement rates, and subject organizations to a wide range of government incentives or penalties. Most would agree that quality measurements […]

HCIM Launches the Healthcare Strategic Advisory Council (HSAC)

HCIM Launches the Healthcare Strategic Advisory Council (HSAC)

HealthCare Information Management, Inc. (HCIM), provider of robotic claims automation software and consulting services, has formed the Healthcare Strategic Advisory Council (HSAC), an industry think tank designed to provide insight and guidance related to technology, process improvement, data integration, operational transformation, and regulatory compliance. “The healthcare landscape is evolving at an unprecedented pace and organizations […]

Transformation from Volume to Value

Transformation from Volume to Value

The industry is responding very slowly to the move to Value-Based Care. Instead of taking steps to move forward with a new model of care delivery and creative payment models, everyone is waiting for the next CMS edict or decision from Congress. The industry should be examining the inefficiencies in the current system, determining how […]

Broadening the Definition of Value in Value-Based Medicine

The healthcare industry needs to broaden the definition of value in value-based medicine. By expanding our view, we’ll discover new and better methods of compensation that incentivize efficiency in medical practice and enhance relationship-based care. Most value-based compensation has been built around clinical outcomes and this is appropriate, but we should also add incentives for […]

Congratulations to Michael Wilson!

We are proud to announce that Michael Wilson, President and CEO of HealthCare Information Management, Inc. has just been elected to the WEDI (Workgroup for Electronic Data Interchange) Board of Directors. This is a two-year term beginning January 1, 2017 and he will serve as a Board Director representing Vendor Organizations. As a Board Director, Michael […]

Michael Wilson Outlines the Data Integration Challenge in Healthcare Tech Outlook Magazine

HCIM President and CEO Michael Wilson provided his insight into the challenge of healthcare data integration in a Healthcare Tech Outlook Magazine article entitled “The New Health Information Integration Challenge – Opportunity or Obstacle?” He explains how healthcare technology companies must find a way to connect payers and providers in an efficient and affordable manner in order […]

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 […]

Leverage technology to uncover hidden ROI in your claims audit process

Leverage technology to uncover hidden ROI in your claims audit process

Many operational errors go undiscovered in the healthcare payer industry. For payers, one of the most costly hidden errors occurs during prepayment claims processing. The magnitude of this problem is significant, as this represents a $2 billion annual expense from costs related to overpayments, rework, provider disturbance, and recovery efforts. Across the payer industry, the […]

How to Achieve Value-Based Healthcare Transformation

How to Achieve Value-Based Healthcare Transformation

HCIM’s Strategic Consulting mission is to collaborate with healthcare organizations in developing and executing a Value-Based Care Transformation Plan. We utilize a continuous process improvement model and an architectural approach based on medical expense management, appropriate revenue optimization, and administrative cost containment. HCIM’s Value-Based Care Transformation Methodology: Assist with defining a vision for your organization’s […]

Are You Ready to Transition to Value-Based Healthcare?

The goal of HCIM’s expanded Strategic Consulting unit is to assist organizations with assessing, planning and charting out a future road map to transform their current business model (strategy, operations, medical management and financial stability) to one that ensures they achieve results and realize success in true value-based care. In this video, HCIM President and CEO, […]

CMS Releases Updated 2016 Medicare Physician Fee Schedule

CMS posted the revised 2016 Medicare Physician Fee Schedule this week. Please note that the new conversion factor is 35.8043 instead of 35.8279 and there was a $0.19 reduction in the anesthesia national conversion factor. SymKey® can help adjudicate your claims from Jan. 1 forward whether you already processed your Medicare claims and need to reprocess them or if […]

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 […]

HCIM Launches a Strategic Consulting Practice Focusing on Healthcare Transformation

HCIM Launches a Strategic Consulting Practice Focusing on Healthcare Transformation

WALNUT CREEK, Calif., Nov. 18, 2015 — HealthCare Information Management, Inc. (HCIM) is announcing the expansion of its consulting service offerings to include a Strategic Consulting Practice focusing on navigating the future transformation of the healthcare marketplace. This new initiative is driven by two industry executives with over 75 years of combined healthcare operations and technology experience […]

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 […]

Top 10 Claims Audit Best Practices

Top 10 Claims Audit Best Practices

The Need for Increased Payment Accuracy With U.S. healthcare claims processing and payment error rates ranging from 7-10% and administrative costs to reconcile those errors exceeding $7 billion, there’s plenty of room for improvement and a significant savings opportunity for those organizations looking to improve their claims audit process. Top 10 Claims Audit Best Practices […]

What is the HIPAA Omnibus Rule and how does it affect me?

What is the HIPAA Omnibus Rule and how does it affect me?

In 2013, the Department of Health and Human Services (HHS) strengthened the enforcement of HIPAA and HITECH with the final omnibus rule (omnibus is a Latin term meaning “for everything”). But many covered entities and their business associates do not realize the legal ramifications of this rule. Because some of the largest HIPAA-related breaches that […]

Why should the U.S. move from ICD-9 to ICD-10?

Carl Natale wrote today in his article “ICD-10 Data: Why U.S. healthcare needs to move on from ICD-9 coding” that while many opponents of ICD-10 say that it won’t improve patient care, the fact is that it will – just not right away. Compiling enough data to make a significant difference can take years, but […]

What do the Midterms Mean for Obamacare?

In the aftermath of the 2014 midterm elections where Republicans gained control of the Senate and maintained control of the House, America is wondering what all this means for the Affordable Care Act. Junior Republican Senator Ted Cruz of Texas had already vowed to dismantle Obamacare once Republicans secured both chambers of Congress, but is […]

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 […]

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 […]

HHS Releases Proposed Rule Regarding Certification of Compliance for Health Plans

January 2, 2014 – The Department of Health and Human Services (HHS) published a proposed rule today regarding certification (also referred to as attestation) under the Affordable Care Act, which is open for comments through March 3, 2014. Certification Requirements The 100-page CMS-0037-P proposed rule would require a controlling health plan (CHP) to submit information […]