Claims Module
SymKey processes claims 8x faster than humans and with 100% accuracy, allowing your staff to focus on more complex tasks.
Designed specifically for payers, SymKey processes healthcare claims 8x faster than a claims examiner, with 100% accuracy, and can be scheduled to run 24/7. Built to work seamlessly with your existing claims platform. Seamlessly integrating with your existing claims platform, SymKey operates through your system’s front-end interface, maintaining a secure, auditable trail for every processed claim. Whether handling routine updates or complex claims adjustments, this cost-effective solution boosts productivity, reduces turnaround times, and transforms the way payers manage claims.
Increase Auto Adjudication
Users experience boosts of 30 percentage points or more in their auto-adjudication rates. Often reaching rates of 90% or better.
Faster Turnaround Times
SymKey works 8x faster than a person and can run 24/7. One client cleared their 30,000 claim backlog within 1 week.
Real Savings
SymKey is cost-effective and purpose-built software that delivers 11x ROI. Users see an average annual savings of 10 FTEs or more.
Risk-Free Trial
We understand that implementing new technology can be daunting. That’s why we offer a flexible opt-out option. If SymKey doesn’t meet your expectations, opting out is hassle-free. However, we’re confident that our solution’s speed, accuracy, and ROI will deliver rapid results.
Capabilities
SymKey can touch and edit virtually any claim header or detail line field in your claims system, automating an unending list of your manual workflows. Some examples include:
Reprocess Paid Claims
Retroactively Adjust Claims
Add Notes
Exception or Outlier Claims
Add a Claim Line
Apply CARCS and RARCS
Match Authorizations
Deny Claims
can do for you.
How It Works
Step One
|
Implementation
HCIM’s staff works with your team to document common processes and programs these workflows into SymKey. Clients are typically up and running in production within 3 days, resulting in a rapid ROI.
Step Two
|
Schedule SymKey
Simply tell SymKey which workflows to run and when, resulting in 24/7 productivity that will virtually eliminate backlogs. You can monitor the progress of claims batches and make changes at any time.
Step Three
|
Analyze results
Review and analyze your SymKey reports to refine and optimize your workflows. Users can customize and update workflows as required. Redeploy your staff to work on more critical tasks.
Step four
|
Innovate
Revisit your top pend reasons to identify new opportunities and continue to automate workflows. While your claims are being processed by SymKey, your staff is now available to focus on work that requires human intervention.
From The Blog
Medicare Advantage Key Updates
Important 2026 Updates for Medicare Advantage: Enhanced Provider Directories and Streamlined Prior Authorization The Centers for Medicare & Medicaid Services (CMS) are set to implement new regulations for Medicare Advantage
SymKey Unlocks: Eliminating Unwanted Duplicate Lines
Claims are divided into two primary parts: the claim header, which contains essential details like member, provider, and location, and claim lines, which represent the services performed. While this structure
Flexible and Efficient Automation: SymKey Query Builder and Scheduler Features
As healthcare providers continually seek ways to improve efficiency, SymKey’s user interface delivers flexible automation and user-friendly features. Query Builder and Query Sequencer: Craft SQL statement and Query Sequencer that
