EncoderPro.comOptum
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Virtual ExaminerPCG Software
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Related Products
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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and coverage determination policies, automated edit review options for proper unbundling and modifier use, and a historical content database for adjudication reference.
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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.
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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
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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
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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
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Audience
Healthcare organizations that want to enhance their current claims adjudication system
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Support
Phone Support
Supported
24/7 Live Support
Not Supported
Online
Supported
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Support
Phone Support
Supported
24/7 Live Support
Not Supported
Online
Supported
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API
Offers API
Not Supported
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API
Offers API
Not Supported
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Screenshots and Videos |
Screenshots and Videos |
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Pricing
No information available.
Free Version
Not Supported
Free Trial
Not Supported
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Pricing
No information available.
Free Version
Not Supported
Free Trial
Not Supported
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Reviews/
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Reviews/
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Training
Documentation
Supported
Webinars
Not Supported
Live Online
Supported
In Person
Not Supported
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Training
Documentation
Supported
Webinars
Not Supported
Live Online
Not Supported
In Person
Not Supported
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Company InformationOptum
United States
www.optumcoding.com/online-coding/encoderpro-spotlight/
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Company InformationPCG Software
Founded: 1984
United States
pcgsoftware.com/product-offerings/virtual-examiner/
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Categories |
Categories |
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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
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Integrations
No info available.
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Integrations
No info available.
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