Virtual Examiner

Virtual Examiner

PCG Software
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About

Automated end-to-end claims platform with AI decision models for data acquisition, policy & coverage checks, medical coding & consistency checks. Reduce leakage and improve your loss ratios with our robust & specialized AI fraud, waste, and abuse detection models for health and life. Qantev enhances the performance of health and life insurers around the globe, helping them reduce losses, optimize their processes, and increase client satisfaction. By blending artificial intelligence with medical expertise, our team of specialized data scientists and engineers has built innovative solutions that boosts the claims management process and uncover instances of fraud, waste, and abuse. Specialized and contextual AI-driven tools to capture, clean, enrich & digitize data from any type of claims document, in any language. Improve your medical provider network's performance through automated AI-driven insight, pricing gap detection, strategy recommendations, simulations, and more.

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

Insurers looking for a solution to reduce losses, optimize their processes, and increase client satisfaction

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

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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

Qantev
Founded: 2018
France
www.qantev.com

Company Information

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

Alternatives

Context 4 Health Plans Suite

Context 4 Health Plans Suite

Context4 Healthcare

Alternatives

iVEcoder

iVEcoder

PCG Software
Artsyl ClaimAction

Artsyl ClaimAction

Artsyl Technologies
ediLive!

ediLive!

Texas Medical Systems

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 Qantev and update features and information
Claim Qantev and update features and information
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