Streamlining Payment Processing: A SymKey Success Story
Ensuring the payment process is accurate, efficient, and timely is crucial for healthcare payers. The SymKey Payment Processing Module is a tool to help streamline the check run process and provides flexibility to make corrections and safeguard proper payment. SymKey Payment Processing Module runs against the claim system database and via Excel or CSV files […]
Understanding the Upcoming Changes in Drug Prices and STLDI Plans
In a major move toward healthcare reform, the HHS along with the Departments of Labor and the Treasury have proposed provisions that address critical issues in the realms of prescription drug pricing and Short Term, Limited-Duration Insurance (STLDI) plans. These actions reflect a commitment to empower consumers and ensure they have access to quality healthcare […]
SymKey Unlocks Efficiency: 10-Month DME Simplified
Manual claims processing can be a costly, time-consuming process marred by potential errors. This is especially true for Durable Medical Equipment (DME) 10-month rentals, which are a complex but crucial part of patient care. Physicians order equipment that provides therapeutic benefits to the patient, and these rentals cover a period of 10 continuous months, at […]
CMS Proposed Changes: Enhancing Healthcare Access and Coordination
In a significant stride towards improved healthcare, the Centers for Medicare & Medicaid Services has unveiled its calendar year (CY) 2024 Medicare Physician Fee Schedule (PFS) proposed rule. The comprehensive update outlines a vision for improved coverage, increased access, and more equitable healthcare. New Codes and Payments for Underserved Populations: To bridge healthcare disparities and […]
Data Integrity: Are you putting your organization at risk?
For many payers, mundane tasks such as claim adjustments, recoupments, and retroactive changes are relegated to SQL scripts for the perceived benefit of freeing up more time in their examiner’s day. While this seems like an efficient practice that allows staff to focus their attention on more complex tasks, many organizations are unaware that while […]
Enhancing Healthcare Transparency: What You Need to Know
In a recent appearance before the House Energy and Commerce Committee’s Subcommittee on Health, Centers for Medicine & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure spent some time shedding light on the agency’s most recent efforts. Her testimony included highlighting the agency’s work in implementing the Inflation Reduction Act, which reduced out-of-pocket drug costs for seniors, […]
Healthcare Spending: 5 Key Post-Pandemic Cost and Utilization Trends
The COVID-19 pandemic sent shockwaves through the healthcare industry, disrupting healthcare spending and utilization patterns, and leaving a noticeable impact on how we approach healthcare. Recent data from the Health Care Cost Institute‘s 2021 health care cost and utilization report, a report based on a collection of claims from commercial payers like Aetna, Humana, Kaiser […]
Case Study: Streamlining Provider Data Management with the New SymKey for EZ-CAP Provider Module
Maintaining Provider Data accuracy is one of the most common challenges for payers in the healthcare industry, and good reason. It can be overwhelming and, at times, very challenging to keep up with constant weekly and monthly changes to ensure that data is updated promptly, especially when it’s a large provider data update. But as […]
Health Plans Continue to Struggle with Inaccurate Provider Directories
Unexpected medical bills are a common issue that many patients face. In 2020, the Federal government passed the No Surprises Act to protect patients from these unexpected bills and increase transparency in the healthcare industry. The No Surprises Act included provisions requiring healthcare payers to make timely updates and maintain their provider directories in an […]
SymKey Case Study
Health Plan Operations Health plan operations are complicated; increasing volume coupled with the demand for qualified claims professionals has made claims management in today’s world, difficult. Even beyond the demands of day-to-day production, claims operations leaders must stay abreast of constantly changing regulations and ensure that their business processes are efficient and up-to-date. Much of […]
