HCIM: Automating Claims Operations for Optimum Efficiency

CIO VendorMichael Wilson, Co Founder President and CEO
With over 30 years of experience in the healthcare industry, Michael Wilson, Co-Founder, President and CEO of HealthCare Information Management, Inc. (HCIM) has been dedicated to serve the healthcare sector with integrity. Looking back over his journey, he says, “Prior to establishing HCIM in 2000, I held management positions in some of the leading healthcare companies, which allowed me to gain insight into claims operations.” Wilson discovered that health plans were facing operational inefficiencies in their claims processing, which drove him to form HCIM to tackle these challenges. Headquartered in Walnut Creek, CA, the company offers a wide range of products and consulting services to the healthcare payer industry.

HCIM’s products are designed to help health plans that are struggling to manually process claims. To reduce the burden on staff, HCIM developed the SymKey® application, which automates repetitive data entry and performs advanced claims adjudication. SymKey® can reach processing speeds of 800 claims per hour, which is 6-8x faster than manually. Integrated with many of the leading claims transaction systems, SymKey® uses pre-programmed artificial intelligence to identify and correct errors accurately and consistently. Another product offering, the SymKey®Benefit Plan Loader allows users to easily modify and update benefit plan terms, and then automatically loads them back into the claims system. In addition, HCIM’s Virtual Auto-Post™ automates the posting of Virtual Examiner® claim edits and recommendations back into the client’s core claims system.

With their products and professional services, HCIM is helping clients to navigate through the changes in technological trends. “Our products and services go hand in hand, where we understand the problem, conceptualize a solution and guide the client on the right path to reach their goal,” states Wilson.
HCIM offers development and operational services, payer system implementations and conversions, and business process re-engineering to enhance their clients’ business growth. Their long standing client relationships have helped them gain a solid reputation in the healthcare payer market. HCIM’s innovative automation products and intuitive understanding of their clients’ pain points have helped them gain momentum in the industry.

Recently, a healthcare payer needed to migrate three different claims systems into one core system and approached HCIM for assistance. Leveraging their consultants’ extensive knowledge and experience, HCIM was able to convert their historical data from all three systems, implement and configure their new system, and re-engineer their businesses processes and workflows using industry best practices. This resulted in new efficiencies and a complete transformation of the client’s operations.

In the future, HCIM plans to expand their product offerings to additional payer claims system platforms and will continue exploring new business opportunities. “Our innovative solutions will bring about a new era of operational efficiencies, where healthcare payers can embrace technological advances while minimizing financial impacts,” concludes Wilson.


Our innovative solutions will bring about a new era of operational efficiencies, where healthcare payers can embrace technological advances while minimizing financial impacts

Company
HealthCare Information Management

Headquarters
Walnut Creek, CA

Management
Michael Wilson, Co Founder President and CEO

Description
Increases the efficiency of healthcare payer claims operations through automated software solutions and professional consulting services.