SymKey’s Reprocess/Pend scenario is a perfect automated solution for adjusting paid EZ-CAP claims 6-10x faster than manually

The SymKey® Reprocess/Pend scenario (available via a query or TXT file) reprocesses EZ-CAP® status 9 paid claims by duplicating the claim and all detail lines, adjusting the original net pay of each line, re-pricing each claim line, adding a Processing Status note to reference the original claim, and then pending the duplicated claim to status 3 for final review by a Claims Analyst. You can combine this with several other actions, such as changing the date received, adding a claim note, and/or adding a claim memo. SymKey® clients have used this scenario for many years to adjust claims due to retroactive fee schedule changes.

For more information, please contact HCIM support at support@hcim.com or call 888-454-0202, option 2.

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.