Alaffia

gainIQ Prevent is a continuous monitoring software that identifies and prevents payment errors in real time. An internal financial control, gainIQ Prevent automatically delivers highly-targeted results that enable your staff to identify errors and irregularities before payment is made. Revenew handles the technical work needed to set up gainIQ Prevent. Once you’ve provided the payment and vendor files from your payment system, we’ll do the rest to get your system integrated, quickly and seamlessly. Our web-based monitoring platform is effective for many types of payment errors, such as duplicate payments. It automatically extracts and analyzes pending and historical payments on a continuous basis, pinpoints possible overpayments, and presents those results to your internal staff. It can be used to evaluate procurement card and T&E transactions as well. gainIQ Prevent comes with a robust claim management and tracking system to ensure timely corrections are made.

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.