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and coverage determination policies, automated edit review options for proper unbundling and modifier use, and a historical content database for adjudication reference.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 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

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 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 Supported
In Person Not Supported

Training

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

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

Medical Coding 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 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 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