CLAIMExpert

CLAIMExpert

Acrometis
Virtual Examiner

Virtual Examiner

PCG Software
+
+

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About

The Acrometis flagship claims processing solution offers unparalleled workflow management, with documents automatically routed by a configurable rules engine. Based around claim assessment scoring, body part to claim compensability matching, jurisdictional directives, relatedness scoring and a host of other claim elements the Acrometis business rules are designed to reduce claim duration and costs. CLAIMExpert automatically processes 65 percent of incoming medical bills and non-medical documents with no user intervention. Documents requiring adjuster intervention are flagged and sorted for easy review and straightforward decision making. Automatically processes incoming documents with NO adjuster intervention. Clients typically see between 11 and 23 points medical loss improvement in the first year. CLAIMExpert contains rules for over 190 different document types, quickly handling whitemail and any other documents that come across your adjuster’s desk.

About

Virtual Examiner®, PCG Software’s flagship product, monitors the internal claims process of an organization to trend provider data for fraudulent and abusive billing patterns, and maximizes financial recoveries. PCG Software’s Virtual Examiner® allows healthcare organizations to enhance their current claims adjudication system with more than 31 million edits per claim. The software solution monitors an organization’s internal claims process to identify unclean claims and reduce payment for improper or erroneous coding to conserve premium dollars. Virtual Examiner® is more than a claims review solution with a focus on code combinations. It is a cost containment solution that evaluates the claim not only for abusive billing patterns but also identifies those claims that may involve third-party liability/coordination of benefits, case management opportunities, physician billing education and many other cost recovery reports.

Platforms Supported

Windows Not Supported
Mac Not Supported
Linux Not Supported
Cloud Supported
On-Premises Not Supported
iPhone Not Supported
iPad Not Supported
Android Not Supported
Chromebook Not Supported

Platforms Supported

Windows Not Supported
Mac Not Supported
Linux Not Supported
Cloud Supported
On-Premises Not Supported
iPhone Not Supported
iPad Not Supported
Android Not Supported
Chromebook Not Supported

Audience

Companies searching for a automated Claim Handling Process solution

Audience

Healthcare organizations that want to enhance their current claims adjudication system

Support

Phone Support Supported
24/7 Live Support Not Supported
Online Supported

Support

Phone Support Supported
24/7 Live Support Not Supported
Online Supported

API

Offers API Not Supported

API

Offers API Not Supported

Screenshots and Videos

Screenshots and Videos

Pricing

No information available.
Free Version Not Supported
Free Trial Not Supported

Pricing

No information available.
Free Version Not Supported
Free Trial Not Supported

Reviews/Ratings

Overall 0.0 / 5
ease 0.0 / 5
features 0.0 / 5
design 0.0 / 5
support 0.0 / 5

This software hasn't been reviewed yet. Be the first to provide a review:

Review this Software

Reviews/Ratings

Overall 0.0 / 5
ease 0.0 / 5
features 0.0 / 5
design 0.0 / 5
support 0.0 / 5

This software hasn't been reviewed yet. Be the first to provide a review:

Review this Software

Training

Documentation Supported
Webinars Not Supported
Live Online Not Supported
In Person Not Supported

Training

Documentation Supported
Webinars Not Supported
Live Online Not Supported
In Person Not Supported

Company Information

Acrometis
Founded: 2002
United States
www.acrometis.com/our-solutions/claimexpert-and-associated-services/

Company Information

PCG Software
Founded: 1984
United States
pcgsoftware.com/product-offerings/virtual-examiner/

Alternatives

Newgen Claims Processing

Newgen Claims Processing

Newgen Software

Alternatives

iVEcoder

iVEcoder

PCG Software
Claims Software

Claims Software

Claim Ruler
Artsyl ClaimAction

Artsyl ClaimAction

Artsyl Technologies
ClaimBook

ClaimBook

Attune Technologies
CyberSource Medical

CyberSource Medical

ComCom Systems
Context 4 Health Plans Suite

Context 4 Health Plans Suite

Context4 Healthcare

Categories

Claims Processing Supported

Categories

Claims Processing Supported
Medical Billing Supported
Medical Coding Supported

Claims Processing Features

Adjustor Management Supported
Case Management Supported
Claim Resolution Tracking Supported
Co-Pay & Deductible Tracking Supported
Compliance Management Supported
Customer Management Supported
Electronic Claims Supported
Forms Management Supported
Paper-Based Claims Not Supported
Payor Management Supported
Policy Administration Supported

Claims Processing Features

Adjustor Management Supported
Case Management Supported
Claim Resolution Tracking Supported
Co-Pay & Deductible Tracking Supported
Compliance Management Supported
Customer Management Supported
Electronic Claims Supported
Forms Management Supported
Paper-Based Claims Supported
Payor Management Supported
Policy Administration Supported

Medical Billing Features

Claims Processing Supported
Claims Scrubbing Supported
Code & Charge Entry Supported
Compliance Tracking Supported
Customizable Dashboard Supported
Dunning Management Supported
Invoice History Supported
Patient Eligibility Checks Supported
Practice Management Supported
Quotes/Estimates Supported
Remittance Advice Supported

Integrations

No info available.

Integrations

No info available.
Claim CLAIMExpert and update features and information
Claim CLAIMExpert and update features and information
Claim Virtual Examiner and update features and information
Claim Virtual Examiner and update features and information