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 created outside of SymKey by hand or generated by other reporting tool. SymKey can change the Claim Status code on a claim as follows:
Move status from 1 to 5
This step moves the list of claims into the first of the payment process.
Move status from 5 to 1
There are cases when certain claims have been moved to status 5, but have been identified as claims that need to be removed from the check run for further review.
Release Encounters, moving from status 1 to 9
The Release Encounters feature allows encounters to easily be moved directly to status 9.
Before leveraging SymKey to help improve this process, HCIM clients faced the daunting task of pre-auditing claims for across multiple EZ-CAP companies, prior to check run. Forcing clients to rely on Excel spreadsheets and unreliable macros. Time-consuming? Absolutely. Prone to errors? Unfortunately, yes. Timely check runs were hanging in the balance every week and clients needed a better solution.
Our SymKey support team created templates for pre-auditing claims, customized process design, conducted live payment processing runs, and trained the client’s team how to run the payment process more efficiently.
With SymKey’s Payment Processing module and our expert guidance, the client achieved remarkable results. One client now processes claims for each of their five EZ-CAP companies weekly, consistently completing each within two to three hours. The worry of missing check-run deadlines is a thing of the past.
This success story is a just one example of how SymKey services can transform challenges into streamlined, efficient, and reliable solutions. Contact us today to learn more about how we can help your organization turn complexity into simplicity.