Virtual ExaminerPCG Software
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Related Products
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About
Efficient checks, integrated expertise and a high degree of automation reduce the transaction costs of vouchers to a minimum. Sumex Core is the basis for automated electronic invoice verification. It contains the business components and workflows, which can be assembled and parameterized in a modular way. Current and correct tariff and reference data are central to efficient invoice verification. Sumex reference data is compiled from publicly available sources, processed in a timely manner and made available on the Sumex tariff server. The data is additionally presented in an information system and can be consulted directly by the experts in the context of the current billing. DRG Expert supports the controlling of billing for services in acute care, created according to SwissDRG regulations. DRG Expert presents case data in the context of regulations, contains statistical key figures and offers what-if analyses.
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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
Mac
Linux
Cloud
On-Premises
iPhone
iPad
Android
Chromebook
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Platforms Supported
Windows
Mac
Linux
Cloud
On-Premises
iPhone
iPad
Android
Chromebook
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Audience
Companies searching for a flexible workflow solution for automated processing of claims documents
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Audience
Healthcare organizations that want to enhance their current claims adjudication system
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Support
Phone Support
24/7 Live Support
Online
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Support
Phone Support
24/7 Live Support
Online
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API
Offers API
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API
Offers API
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Screenshots and Videos |
Screenshots and Videos |
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Pricing
No information available.
Free Version
Free Trial
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Pricing
No information available.
Free Version
Free Trial
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Reviews/
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Reviews/
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Training
Documentation
Webinars
Live Online
In Person
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Training
Documentation
Webinars
Live Online
In Person
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Company InformationSumex
Founded: 2019
www.sumex.ch/en/Sumex-Suite
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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
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
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Integrations
Siddhartha
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