Empowering Kindness: How Ben’s Bells Strengthen Communities
At our recent 2024 All Colleague Meeting, the HCIM team came together to collaborate, celebrate, and take time to embrace the spirit of community and kindness. Our colleagues participated in a mobile studio session with Ben’s Bells, painting ceramics destined for the community. This event wasn’t just about crafting beautiful ceramics but a profound exercise in […]
Reduce Manual MIPS Adjustments with SymKey
The 2024 updates to the Merit-based Incentive Payment System (MIPS) significantly impact healthcare professionals, influencing both management practices and compensation for Medicare Part B services. With eligibility criteria encompassing everything from patient volumes to service thresholds, MIPS has set a complex standard that demands precise compliance and operational efficiency. While many Core administrative systems have […]
How SymKey Simplifies Sequestration
Sequestration, a common hurdle for any healthcare payer under Medicare’s Fee-for-Service (FFS) program, often involves tedious manual processes. Let’s delve into this challenge and discover how SymKey frees you from this time-consuming burden. What is Sequestration? Simply put, it’s a federal budget control measure that reduces the amount Medicare pays to providers through mandatory reductions […]
A Closer Look at the Medicare Prescription Drug Inflation Rebate Program
The launch of the Medicare Prescription Drug Inflation Rebate Program is a vital development for the financial and medical well-being of millions of Americans, specifically designed to ease the financial burden of prescription medications for seniors and individuals with disabilities. By instituting an annual out-of-pocket (OOP) cap on drug costs, the program not only alleviates […]
SymKey Unlocks: Simple Solution to Medi-Cal’s Targeted Provider Rate Increase
The recent California Department of Health Care Services (DHCS) amendment to the AB 118 bill has Medi-Cal managed care health plans working overtime implementing this bill. This provision is increasing Medi-Cal rates for eligible contracted providers to equal no less than 87.5% of the lowest Medicare rate who supply treatment for certain Medi-Cal services rendered […]
HCIM Cares: HCIM Leadership Embraces Community Service at the Durham Rescue Mission
North Carolina’s capital, Raleigh, played host to HCIM’s recent Leadership Team Meeting. In the midst of strategic discussions, the team took a meaningful detour to support the local community. Their destination was the Durham Rescue Mission, the oldest homeless shelter in the Durham, Raleigh, and Chapel Hill area. Founded in 1974 with a steadfast mission […]
How a Leading ACO Overcame Systemic Challenges with SymKey
A leading ACO (Accountable Care Organization) and medical group manager faced significant challenges with its claims adjudication processes due to poorly designed auto-adjudication rules. These rules caused continuous claim cycles, creating ongoing issues. Their wide range of operations across rural areas, multiple service organizations (MSOs), and specialized environments, further complicating the situation. Facing the Adjudication […]
Scaling New Heights: The Strategic Advantage of Additional SymKey Robots
When faced with increasing claims volumes or special projects like large-scale reprocessing, many healthcare payers look to traditional solutions such as hiring more staff or mandating overtime for existing staff. Both options come with drawbacks; hiring can be a lengthy process along with significant training investment. Even temporary help requires training and supervision that often […]
CEO Insight: Healthcare Trends to Watch
The healthcare payer landscape changes almost daily and it can be hard to see the forest through the proverbial trees. It’s easy to get focused on the day to day and miss important trends that may have significant impact down the road. As we look to the future, it’s important to keep these key trends […]
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 […]