FAQ: Why does SymKey’s input file for Batch Processing look different than files for the other modules?

Answer: SymKey’s Batch Processing module is an advanced tool that allows users to combine multiple actions into one batch. The Professional and Hospital Claims modules, on the other hand, contain standard scenarios that are predefined and coded within the SymKey software. The Professional and Hospital Claims modules’ input files typically contain the claim number and at times other criteria such as line numbers or authorization numbers needed to complete the selected scenario. The benefit of these modules is that changing the same criteria (copay, capitation, denials) on a large number of claims can be accomplished with very little setup from a user’s perspective.

The Batch Processing module has the ability to combine groups of these actions, and many more, into a single batch. It also treats each claim or line number in the batch individually. For example, you can specify one copay amount for one claim number and a different copay amount for the next claim in the batch and so on. For this reason, SymKey needs to know which fields are going to be manipulated and the action to be taken on them. These requirements cause the input files to look differently than those in other modules.

Professional/Hospital Claims Module Input File Examples
Claim Number Only
2010010199900002
2010010299901030
2010010243700734

Claim and Line Numbers
2010010199900002,2
2010010299901030,4
2010010243700734,1

Batch Processing Module Input File Example
claimno,sequence,copay,status,forcestatus
2010010199900002,2,5,3,Y
2010010299901030,4,10,1,Y
2010010243700734,1,0,3,Y

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.