ICD-11 Digitizes Global Healthcare Coding Practices
The purpose underlying the International Classification of Diseases (ICD) manuals is to establish a common language to organize and identify diseases and their impacts on human lives. The recent release of ICD-11 promises to further enhance the understanding and control of global diseases. Transitioning to ICD-11 isn’t required until 2022, but medical coders will want […]
4 Factors Driving Rising Healthcare Insurance Premiums in 2019
Did you know that health insurance companies are already at work setting their premiums for 2019? This year, that endeavor may be more challenging than in previous years; politics, evolving medical costs and actions by independent states are all contributing to the rise of healthcare insurance premiums. Key drivers for premium changes According to the […]
Southern California MSO using AI to increase claims processing productivity
While many businesses are still looking for ways to harness new technology, Southern California Physicians Managed Care Services (SCPMCS) has been leveraging artificial intelligence to increase the productivity of their claims team since 2009. Using HCIM’s SymKey® solution, SCPMCS has been able to automate both routine and on-the-fly claims processing workflows for the past nine […]
The Evolution of Data, Social Determinants, and AI in Population Health Management
Population Health Management is the new foundation in the successful shift to value-based care and is evolving beyond risk management. It’s currently focused on understanding who the most vulnerable of our patients are, but true Population Health Management necessitates a more thorough collection of patient data across all spectrums and an in-depth analysis of that […]
How to Automate the Reprocessing of Medicare FFS Claims Due to the Bipartisan Budget Act of 2018
Healthcare payer organizations that use the Medicare fee schedule must begin reprocessing claims as of last week. Due to provisions in the Bipartisan Budget Act of 2018 that was passed on Feb. 9, CMS issued Change Request 10531 directing payers and Medicare Administrative Contractors (MACs) to reprocess FFS claims relating to Medicare Extenders (the Medicare […]
The Business of Bots: The SymKey® Effect
HCIM has been in the business of bots for over 15 years, operating exclusively in the healthcare claims industry. Our passion has always been to optimize processes through Robotic Artificial Intelligence. SymKey® automates manual repetitive claim actions while at the same time thoughtfully applying business rules and ensuring quality claim payment. Clients enjoy the fast turnaround times, […]
There’s No Shortage of AI Specialists Here
A recent Ernst & Young study revealed that a shortage of artificial intelligence experts is impeding the ability of companies to adopt the technology. In fact, over half of the executives surveyed claimed the lack of available talent prevented them from integrating AI into their business operations. This directly impacts their competitive advantage in streamlining […]
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 […]
Healthcare Executives Use AI to Reduce Administrative Burden
According to the following MCOL infographic, 23% of the healthcare executives that were surveyed stated that the greatest opportunity provided by Artificial Intelligence (AI) is that it reduces their administrative burden. SymKey® clients have been using AI to automate their healthcare claims processing since 2002. Robotic Process Automation (RPA) allows payers to process more claims […]
Are You Still Processing Claims by Hand?
Processing your claims manually is like washing laundry by hand. Sure, it works. But why would you do it manually when you can use a machine to do the same work both faster and more accurately? SymKey® can handle your boring, mundane work, because I’m sure you have better things to do! Just load your […]
