SymKey® uses robotic automation to process healthcare claims more efficiently through programmed artificial intelligence. Anything that a claims examiner can do, SymKey® can do faster and with 100% accuracy, allowing your staff to focus on more complex tasks. Since it runs entirely through the frontend of your claims system just like any user would, your IT department can rest assured that everything is secure.
How it Works
Step 1: Installation
HCIM’s staff comes to your office to document common processes and program these workflows into SymKey®. Clients are typically up and running in production within 3 days, resulting in a rapid ROI.
Step 2: Schedule SymKey®
Simply tell SymKey® which workflows to run and when, resulting in 24/7 productivity that will virtually eliminate backlogs. You can monitor the progress of claims batches and make changes at any time.
Step 3: Innovate
Continue to automate new workflows as you’ll find there are endless uses for SymKey®. While your claims are being processed by SymKey®, your staff can work on more complex tasks that require human intervention.
What Can SymKey® Do?
With the ability to touch and edit virtually any claim header or detail line field in your claims system, SymKey® can automate an unending list of your manual workflows, including:
Reprocess Paid Claims
Reprocess to correct prior paid amounts due to identified over/underpayments
Copy and Reverse
Create an exact claim copy for reworking and reversing paid claims
Retroactively Adjust Claims
Reprocess and adjust claims due to retroactive changes to CMS fee schedules, contracts, and benefit plans
Compare unpaid with paid claims and deny exact duplicate claims or hard dups based on specific criteria
Manually Price Claims
Price unpaid claims due to edits, bundling, fee schedule updates, copay/coinsurance, or outlier contract pricing
Link claims to authorizations based on your predefined matching criteria
Apply CARCs and RARCs
Apply CARCs and related RARCs according to CMS guidelines for adjusting claim lines
Pend for Further Review
Pend claims for examiner audits, high dollar review, or other pre-check run edits
Add a Claim Line
Add additional claim detail lines due to bundling/unbundling or splitting lines (i.e. split Professional and Technical)
Deny based on eligibility, timely filing, benefit limitations, financial responsibility, etc.
Add unlimited claim notes, memos, or other user defined fields in a consistent manner
Apply claims processing override codes and/or actions
All-Inclusive Licensing, Maintenance, and Support
We use a budget friendly SymKey® licensing model that includes installation, training, support, maintenance, upgrades, and documentation. There are no hidden fees and we don’t charge per claim – use it as much as you want for a fixed cost. HCIM’s product support team is always here for you. We love helping our clients find new and innovative ways to use SymKey® to improve their productivity and make their work easier. It’s truly our passion. Read what our clients have to say >>
Try SymKey® Risk-Free
We offer a 30-day test drive so you can see our SymKey® healthcare claims processing software in action. We’ll configure the most common workflows to quickly increase your auto-adjudication rate and train your staff on how to automate on the fly. Our product team is very responsive and available to address any questions you may have. Complete the form below to learn more about this offer that’s too good to pass up. Once you see it in action, you’ll wonder how you ever survived without SymKey®!