The Problem North American Medical Management of Illinois, Inc. (NAMM-IL) was recently impacted by a retroactive fee schedule change that involved processing over 300,000 claims on top of their current
NCHS and CMS have published General Equivalency Mappings (GEMs) as a translation reference between I-10 and I-9 diagnosis and procedure codes. These “one-to-one” mappings translate one I-10 code to either one I-9 code
While SymKey’s Batch Processing module allows you to create virtually limitless custom scenarios to modify or process claims, there are also several pre-programmed scenarios built into the SymKey® Professional and
HCIM has just raised the bar in healthcare payer consulting services with a groundbreaking Performance Assurance pledge. We pledge to deliver professional, competent, and affordable consulting services to the agreed-upon
Don’t lose sight of the ICD-10 deadline! October 1, 2013 is closer than you think… Did you know? You should have already completed ICD-10 impact assessment, risk analysis, and mitigation
Many people still believe that the new ICD-10 CM and PCS code set transition from ICD-9-CM will simply involve one-to-one mapping, but it will also require one-to-many general equivalency mappings
Over the span of my career, I have led or been involved in numerous system installations and conversions. It seems like each project involves an out of date or unsupported
HCIM’s SymKey® Kwik Actions™ application increases the efficiency and productivity of Claims Operations staff by automating routine tasks within and around their health care benefit administration system. Kwik Actions are
According to the RAND Science and Technology Policy Institute’s comprehensive technical report on The Costs and Benefits of Moving to the ICD-10 Code Sets, providers will incur costs for computer reprogramming, the training
Continuing economic pressures and recently enacted Health Care Reform mandates place additional pressure on all health plans and managed care/payers to improve their operational efficiencies and reduce associated costs. Future reductions
Yes, SymKey’s “Reprocess/Pend” standard scenario is a perfect automated solution for repricing paid claims and is very simple to use for EZ-CAP status 9 claims. Create a .txt file with
CMS Progress in Implementing the New Standards CMS is well into the process of readying its FFS Medicare systems to handle the 5010/D.0 standards. All Medicare systems will be ready