Spotlight on Desert Oasis Healthcare (DOHC)

After a successful 30-day risk-free trial, Desert Oasis Healthcare (DOHC), a subsidiary of Heritage Provider Network, Inc., licensed the SymKey® 2.0 for EZ-CAP® 6.x Virtual Auto-Post™ (VAP) module on May 1, 2012. VAP automates the posting of PCG Software Inc.’s Virtual Examiner®/Reporter® (VE/VR) claims recommendations into the EZ-CAP® system. “We were looking to increase examiner production by having edits automatically applied and processing notes posted to the claim,” said Lisa Giminez-Kerstetter, Claims Supervisor at DOHC.

“SymKey Virtual Auto-Post freed up examiners from having to manually enter adjustment codes by having VAP do the work. VAP is fast and accurate. Efficiency is the name of the game,” said Clare Abadie, Claims Director at DOHC. Prior to VAP, DOHC staff spent 60-75 hours per week posting VE/VR recommendations into EZ-CAP. Now their manual edits only take 10-15 hours per week. That means they’re performing the same processes of posting VE edits with 81% less staff hours. “It is AWESOME, and everyone that we have worked with at HCIM has been accommodating,” said Jeanna Erdahl, Claims Examiner at DOHC.

DOHC expects to realize additional time savings through further utilization of VAP as they identify additional scenarios they can automate. “The more innovative we are, the more we realize how SymKey can be utilized,” said Clare Abadie. “We have a new saying around DOHC, ‘How did we ever live without SymKey Virtual Auto-Post?’”

DOHC first licensed the SymKey for EZ-CAP Professional Claims and Payment Processing modules in 2004. In 2011 alone, DOHC processed nearly 165,000 claims with SymKey and saved them MANY staff processing hours – and that was before they licensed the Virtual Auto-Post module. “SymKey’s abilities contribute to the success of the department. We LOVE our Symkey and the people behind the product. The customer service is outstanding – they are responsive, helpful, accommodating, friendly, generous with their time and knowledge, and innovative,” said Clare Abadie.

“SymKey is my very best friend. Without SymKey, it would be more difficult to maintain an eight day inventory with current staff,” said Brooke Yates, Claims Data Specialist II at DOHC. Clare added, “SymKey makes life easier by adding memos and notes, applying adjustment codes, correcting information that was in-loaded incorrectly, adding authorizations and case numbers, adding and/or removing copays, copying claims for adjustments, etc.”

“Desert Oasis Healthcare has been a delightful client to work with over the past 7+ years. Their staff has been tremendously enthusiastic about SymKey, declaring it the most productive claims processing tool. They continually look for new ways to use SymKey, through the batch processing of Professional claims and most recently with Virtual Auto-Post. It’s been wonderful working with Clare, Brooke, Lisa, Jeanna, Scott and others there,” said Tom Streeter, HCIM’s Senior Vice President, Product Solutions.

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.