SymKey 3.0 can identify the corresponding Auth IDs for professional claims, automatically populate the authorization, and then reprice all claim lines. As an added bonus, SymKey is able to run unattended around the clock, at speeds averaging over 700 claims per hour. Talk about time savings! And SymKey works within your existing core claims transaction system, just as any other user would – that means no mishaps on the backend.
How does SymKey do it?
For this particular automated workflow, SymKey runs a query to determine the authorization that matches with the professional or hospital claim, based on same member, same vendor, same diagnosis, same line procedure code, and same line date of service, as well as specifying a received date range. There are also additional options for same provider, matching modifiers, excluding temporary members and providers, and focusing only on electronic claims. Depending on your preference, SymKey can perform any number of additional modifications, including applying the Auth ID and repricing the claim, and then either completing the claim, denying it, or pending the claim for review. Because SymKey can touch and modify all the claim header and detail lines, the options are endless.