Streamlining Claims Management

Effective payer provider collaboration is key to reducing the cost of healthcare, and claims management is an integral component of that relationship. As many organizations focus on care management, they must also streamline claims management processes to evolve with changing reimbursement models. Training and new technologies are at the core of claims management improvement. Technology […]

Core System Replacement Considerations for Healthcare Payers

New payment methods, accountable care, consumerism and an increasing demand for effective subscriber engagement and management (which disrupts traditional operating models in the small to mid-sized payer market) are placing enormous pressure on providers to innovate and improve operational efficiency. Outdated core legacy systems may hinder a payer’s ability to respond rapidly to this evolving […]

CEO Insight: Obstacle or Opportunity? Three hurdles facing healthcare payers

These are challenging times for healthcare payers. Increasing aging populations, pressure to cut costs, and a focus on quality is requiring everyone to do more with less. By facing these challenges head-on, we can turn these obstacles into opportunity. It is through continued innovation and experimentation that we will improve health care delivery in this […]

What is the Health Insurance Providers Fee and Who Pays It?

To offset the growing number of uninsured Americans, Congress enacted the Affordable Care Act (ACA) in 2010. With it came provision 9010, establishing the Health Insurance Providers (HIP) fee, a tax that is placed on covered entities that provide health insurance. The intention of this fee was to help fund state marketplaces and exchanges, and […]

4 Things Healthcare Payers Should Consider When Selecting a Consultant

Finding the right professional consultant for your healthcare operations and technology needs can be challenging. Do you go with the cheaper but less professional option? Should you go with the highest bidder with the stellar references? The consultant backed by a massive organization or one from a smaller company that will be more responsive? There’s […]

Why Your Claims Department Needs Better Documentation

With the high turnover rate in healthcare claims departments and the amount of time it takes to fully train new hires, you need quality documentation custom-tailored to your unique business rules, workflows, and organizational structure. This will allow you to bring staff up to speed quickly and to maintain consistent standards throughout all departments, ensuring […]

HCIM’s Concierge Consulting for Healthcare Payers Brings Service to a Whole New Level

Since 2000, HCIM has helped healthcare payer organizations achieve their strategic and operational objectives through applied technology and business process optimization. We love to help clients innovate, solve problems, and improve performance in this ever-changing healthcare environment. Our focus is on improving claims operations and achieving technology-enabled transformations. We spend time analyzing the problem, then […]

HCIM is Your Trusted Resource for EZ-CAP® System Support

Responsiveness and results are critical to the success of your claims operations. HCIM is the only consulting firm with the history, in-depth application knowledge, and the practical hands-on experience to support your EZ-CAP® Benefit Matrix configuration, fee schedule creation and updates, data analytics and report development, project management, and more. For nearly 15 years, we […]

Are you ready for the Open Enrollment Scramble?

As we all know, preparing for all of the configuration updates surrounding Open Enrollment every year can be a huge drain on your staff’s time. Not only do they need to manage their current workload, but they also have to dedicate focused time on analyzing, documenting, and configuring all of the new or updated benefit […]

Are You Ready to Transition to Value-Based Healthcare?

The goal of HCIM’s expanded Strategic Consulting unit is to assist organizations with assessing, planning and charting out a future road map to transform their current business model (strategy, operations, medical management and financial stability) to one that ensures they achieve results and realize success in true value-based care. In this video, HCIM President and CEO, […]