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
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
Finding the right professional consultant for your healthcare operations and technology needs can be challenging. Do you go with the cheaper but less professional option? Should you go with the highest bidder with the stellar references? The consultant backed by a massive organization or one from a smaller company that
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
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
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
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
The healthcare industry remains fractured, divided and entrenched in a bitter political battle. The access and delivery of care is broken and unsustainable. To fix health care, we need a well thought out solution with all parties coming together for the greater good, rather than the short sighted “Repeal and
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
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
If your claims process hasn’t changed in years, it may be time for an upgrade. From your auto-adjudication rate to your claims turnaround times and everything in between, there’s always room for improvement. Claim quality is integral to your bottom line and to maintaining provider satisfaction. HCIM is a pioneer
The Medicare system is set to undergo a drastic change. Starting in the spring of 2018, all Medicare beneficiaries will be transitioning to a new identification system. As part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), this transition is designed to protect millions of Medicare beneficiaries.