Virtual Examiner

Virtual Examiner

PCG Software
+
+

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About

EncoderPro Spotlight by OptumCoding is a web-based medical coding reference application designed to help ambulatory coding, billing, and reimbursement professionals manage critical coding tasks with accurate, real-time access to CPT, HCPCS Level II, ICD-10-CM/PCS, and ICD-9-CM code sets and associated regulatory guidance; the software includes powerful search and reference capabilities that combine thousands of procedure, service, supply, and diagnosis codes with descriptive and cross-coding information so users can find the right codes quickly and reduce errors in claim submission. It provides proprietary content and tools that go beyond basic code lists to include deeper insights into regulatory compliance topics such as National Correct Coding Initiative (NCCI) edits, Hierarchical Condition Categories (HCCs), and coverage determination policies, automated edit review options for proper unbundling and modifier use, and a historical content database for adjudication reference.

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
Mac
Linux
Cloud
On-Premises
iPhone
iPad
Android
Chromebook

Platforms Supported

Windows
Mac
Linux
Cloud
On-Premises
iPhone
iPad
Android
Chromebook

Audience

Medical coders, billers, and health care revenue cycle professionals who need fast, accurate, up-to-date online access to comprehensive coding and compliance reference data to improve coding accuracy and reimbursement outcomes

Audience

Healthcare organizations that want to enhance their current claims adjudication system

Support

Phone Support
24/7 Live Support
Online

Support

Phone Support
24/7 Live Support
Online

API

Offers API

API

Offers API

Screenshots and Videos

Screenshots and Videos

Pricing

No information available.
Free Version
Free Trial

Pricing

No information available.
Free Version
Free Trial

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
Webinars
Live Online
In Person

Training

Documentation
Webinars
Live Online
In Person

Company Information

Optum
United States
www.optumcoding.com/online-coding/encoderpro-spotlight/

Company Information

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

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Categories

Categories

Claims Processing Features

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

Medical Billing Features

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

Integrations

No info available.

Integrations

No info available.
Claim EncoderPro.com and update features and information
Claim EncoderPro.com and update features and information
Claim Virtual Examiner and update features and information
Claim Virtual Examiner and update features and information