MedPOINT Management Processes 480 Claims per Hour with SymKey

MedPOINT Management, Inc. has been an HCIM client since 2010 and upgraded to SymKey® 3.0 in February 2014. MedPOINT has been processing an average of 240 Professional/Hospital claims per hour using SymKey®, which is about 11-19x faster than manually. And since MedPOINT has two SymKey® processing engines, they were able to process an equivalent of 480 claims per hour!

“SymKey® is a valuable tool that every company in healthcare should have. My advice is to use SymKey® as much as you can, because it makes your work as easy as possible. It truly simplifies claims processing. SymKey® has made a huge impact on our claims department,” said Winnie Garcia, Claims Audit Manager at MedPOINT Management.

“The Scheduler and Query Sequencer greatly improved my SymKey® usage. I am able to automate a lot of manual processes, in particular the weekly reprocessing of claims – the person who was doing this prior to SymKey® 3.0 is now part of our audit team and no longer needs to manually correct these claims,” said Winnie.

With the new Scheduler, SymKey® can run around the clock for additional productivity. Winnie explained, “I run SymKey® every night with the Scheduler, which frees up the machine during the day to use as needed.”

MedPOINT also uses SymKey® Virtual Auto-Post to automatically post claim edits from Virtual Examiner® into EZ-CAP®. “For some of our IPAs, Virtual Auto-Post frees up all our auditors from having to manually audit their claims, which gives us more time to pre-audit claims,” said Winnie.

“I have always been impressed with MedPOINT’s extensive use of SymKey®, running hundreds of claims adjudication scenarios every week, as well as many others on an ad hoc basis. Since starting with SymKey® 3.0 for EZ-CAP® 6.x, they have experienced tremendous productivity gains and personnel savings through the use of the new SymKey® Query Builder, Sequencer, and Scheduler,” said Tom Streeter, Senior Vice President, Product Solutions for HCIM.

About SymKey®

SymKey® is a powerful automation tool that performs a predefined series of actions on hundreds of claims at a time within a client’s existing claims system.

  • Seamlessly automates processing within your existing claims system at speeds 6-8x faster than manually
  • With the ability to touch/edit virtually any claim header or detail line field in your claims system, SymKey® can automate an unending list of custom manual workflows, including:
    –  Add a claim detail line
    –  Adjustments
    –  Retro rate reconciliation of fee schedules and benefit changes
    –  Capitation and uncapitation
    –  Attaching an auth or case number
    –  Adding notes or memos
    –  Denying  specific claim lines due to financial responsibility
  • SymKey® can be run 24/7 with the Query Builder, Query Sequencer and Scheduler components

Click here for more information about SymKey®.

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.