FAQ: What is the proper source file format/layout for Professional and Hospital Claims batches?

Answer: The standard format for a SymKey input file is .txt or .csv. Most of the files that SymKey uses to perform batches only contain claim numbers; a text file works the best for these types of batches. Other batches require more information, such as claim detail line numbers or a claim auth in addition to the claim number. In these cases the additional information must be in a comma-separated format. Examples of the input file structure can be seen below.

Standard input file example
2010020499900001
2010020499900245
2010020513400211

Comma-separated file examples
Detail lines needed:
2010020499900232,2
2010020621100110,1
2010020743700087,3

Auth numbers needed:
2010020499900101,2010030100002
2010020499900276,2010030100776
2010020513400277,2010030100433

Batch Processing file:
claimno,sequence,copay,status
2010020499900216,2,10,1
2010020499900780,1,20,1
2010020513400091,6,5,1

About HCIM

Since 2000, HealthCare Information Management, Inc. (HCIM) has delivered expert consulting services and robotic automation tools for small to mid-sized healthcare payer and managed care organizations. Our concierge consulting services include everything from core claims system procurement to go live, including configuration, migration, upgrades, reporting, benefits and fee schedules, user training, and project resourcing. We also offer strategic consulting in the areas of value based payments, population health, medical management, medical loss analysis and recovery, care management, provider contract modeling, data analytics, and business process reengineering/analysis.