La Vida Medical Group and IPA – Lawndale, Calif.

La Vida Medical Group and IPA began a 30-day risk-free trial of the SymKey® for EZ-CAP Virtual Auto-Post™ module in June 2009. Virtual Auto-Post™ works with PCG Software’s Virtual Examiner® and Virtual Reporter® to automatically post claims recommendations.

March Vision Care – Los Angeles, Calif.

March Vision Care has been a client of HCIM since June 2006, and will take their scanning and imaging solution to the next level by licensing HCIM’s ScanClaims™ product suite for full OCR capabilities and a complete claims workflow and inventory management solution, beginning August 2009.

MED3000 – Oxnard, Calif.

MED3000 renewed their SymKey® for EZ-CAP Professional Claims module license for two more years, effective May 2009. MED3000 has been a client of HCIM since May 2006, when they licensed the SymKey® for EZ-CAP Professional Claims module.

North American Medical Management of Illinois (NAMM – IL) – Hillside, Ill.

NAMM began a risk-free trial of the SymKey® for EZ-CAP Virtual Auto-Post™ module in May 2009. NAMM has been a client of HCIM since Nov. 2008, when they licensed the SymKey® for EZ-CAP Professional and Hospital Claims modules.

Physicians Medical Group of Santa Cruz County (PMG) – Santa Cruz, Calif.

After the successful completion of HCIM’s 30-day risk-free trial of the SymKey® for EZ-CAP Professional Claims module and Virtual Auto-Post™ module, PMG entered into a three-year licensing agreement with HCIM for both modules, effective February 2009. “We have been able to move many of our homegrown solutions into the SymKey product, which ensures that the rules are applied accurately and consistently. We will soon be expanding the use of SymKey into more auto-adjudication areas, and we are confident that it will continue to improve our productivity,” said Cindy Martin, the Chief Operations Officer at PMG.

Physicians United Plan, Inc. (PUP) – Winter Park, Fla.

After a successful 30-day risk-free trial period, PUP entered into a three-year licensing agreement for the SymKey® for EZ-CAP Professional Claims module and Virtual Auto-Post™ module, effective March 2009. “We licensed SymKey to minimize our claims processing costs, which allows us to reduce our administrative costs,” said Tom Middleton, the Senior Director of Claims at PUP in Winter Park, Fla. “SymKey is a great product, and I am excited to also be in a 30-day trial of the SymKey® for EZ-CAP Hospital Claims module, which I fully expect to license after the trial period,” said Middleton.

Regal Medical Group – Northridge, Calif.

Regal Medical Group has signed up for a 30-day risk-free trial of the SymKey® for EZ-CAP Hospital Claims module, which will begin in June 2009. Regal has been a client of HCIM since Jan. 2006, when they licensed the SymKey® for EZ-CAP® Professional Claims module.

 

Excel Hospital Claim Files to EZ-LINK®

HCIM developed an Excel Hospital Claim File utility, which imports Hospital encounter data collected by the delegating health plan in an Excel format that is unique to each plan. The utility then cleans up the data and fills in missing key fields with either mapped or constant data specific to each plan, and then creates a text file in EZ-CAP® EZ-LINK® proprietary format, so the client can load the UB encounter data into their claims system for reporting purposes.

 

New Webinar Training Sessions

As part of HCIM’s commitment to providing superior product support, HCIM has begun hosting training webinars (online training seminars) for new product enhancements and functionality. Clients are e-mailed invitations to attend these training webinars. If you did not receive an invitation to the April SymKey for EZ-CAP Batch Processing webinars and would like to be invited to future training webinars, please contact HCIM Product Support at 888-454-0202 or support@hcim.com.

SymKey® for EZ-CAP® Batch Processing Module Webinar – April 2009

If you missed the live HCIM-hosted Batch Processing Module training webinars last April, you can view a recording of the training sessions on HCIM’s website.

Congratulations to the following winners of the $50 American Express gift card raffle prize for webinar attendees:

• Session 1: Marilyn Granthan, Claims Manager at Universal American Corp.
• Session 2: Yonnie Moss, Director of Claims Operations at Managed Care Systems, L.P.
• Session 3: Khaled Ghaly, Director of Claims at Arcadian Management Services, Inc.

Special Recognition

We at HCIM would like to congratulate Amy Sipe, Client Services Consultant at HCIM, on her achievement of QNXT™ Professional. Amy’s Professional certifications include QNXT 2.6, QNXT 3.0, QNXT 3.2, and QNXT 3.4.

“Amy brings a wealth of claims operations experience to HCIM. Her extensive healthcare knowledge, coupled with her successful completion of QNXT Professional Certification, positions her in a distinct class of the few truly qualified QNXT consultants,” said Jeffrey M. Hall, Sr. Vice President and Group Director of Consulting Services at HCIM. “Our clients know the level of commitment required to attain a TriZetto QNXT Professional Certification, as well as the system centric knowledge that is gained from it. QNXT clients place their trust in HCIM, because they demand the highest level of measurable QNXT comprehension – a comprehension that can only be found in a TriZetto Certified Service Partner consultant.”

HCIM to attend 2009 Western Claims Conference

HCIM will be attending the June 14-16, 2009, Western Claims Conference in Indian Wells, Calif.

HCIM to present at MZI HealthCare’s 2009 EZ-CAP® Users Conference

HCIM will be a sponsor at the Oct. 11-14, 2009, 19th Annual EZ-CAP® National Users Conference in Newport Beach, Calif. HCIM will also be presenting on the EZ-CAP 6.0 upgration (upgrade/migration).

“PMG is a small IPA with limited staff, and we have had some challenges with PDRs. We decided to license Appeals Manager™ because we were looking for a product to improve the accuracy of response letters and to increase the efficiency of tracking.”

—Cindy Martin
Chief Operations Officer at
Physicians Medical Group of Santa Cruz County (PMG)

 

Consulting Services

HCIM's Professional Consultants are hands-on experts, trained on many of the leading managed care systems. HCIM’s consultants have extensive experience in Facets®, QNXT™, and EZ-CAP®. HCIM is a TriZetto QNXT Certified Service Partner (CSP). HCIM’s predesigned approach and industry expertise save you time and money. [info]

SymKey®

The first product of its kind, the SymKey application’s advanced automation technology maximizes the performance of core benefits administration systems. HCIM’s various SymKey modules include the functionality for the automated adjudication of professional claims, hospital claims, and authorization requests, as well as the automated posting of claims recommendations, automated work navigation hotkeys, and automated batch processing. [info]

ScanClaims™

ScanClaims delivers unprecedented savings and productivity through state-of-the-art OCR scanning, imaging, data scrubbing, validation, and data management of claims and authorizations. [info]

Appeals Manager™

The Appeals Manager application is a leading edge software product that offers an efficient and automated solution for addressing CA AB1455 appeals and provider dispute resolution processes. [info]

Pay for Performance (P4P)

P4P is a complete pay for performance technology solution that brings together all required data sources and generates accurate P4P measurement results. [info]