InvisaClaim
InvisaClaim AI Revenue Cycle Management that prevents denials and wins the ones that slip through.
The most advanced all-in-one platform for billing companies and RCM teams. Before claims go out, Pre-Submission Check and Pre-Check AI scrub them against NCCI edits, coding conflicts, and payer rules stopping denials at the source. When one slips through, upload or live-feed a denial letter or 835 ERA and AI extracts patient data, CARC/RARC, CPT/ICD-10, amounts, and deadlines then drafts a payer-specific appeal in 60 seconds across 30+ payers.
Modules: Pre-Submission Check, Denial Workbench, NSA/IDR (eligibility, QPA, GFE & IDR letters), Prior Auth, A/R aging, NPI verification, deadline alerts, full audit trail.
Connects to your clearinghouse and EHR: Change Healthcare/Optum, Waystar, Availity, Athenahealth (pipeline), plus a FHIR R4 layer for EPIC/Cerner.
HIPAA Compliant · SOC 2 · 256 Encryption
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Virtual Examiner
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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Paradigm
Paradigm Senior Services offers a full-service, AI-powered revenue cycle management platform specifically tailored to home-care agencies that bill third-party payers such as the U.S. Department of Veterans Affairs (VA), Medicaid, and other managed-care payers. It automates and streamlines every step of the billing and claims process: from eligibility/authorization verification, state- or payer-specific enrollment and credentialing, to submission of clean claims, denial handling, and payment reconciliation. It integrates with common agency management software and electronic visit verification tools to scrub shifts, verify authorizations weekly, and reconcile payments, reducing denials and minimizing administrative burden. Paradigm also supports “back-office as a service” for providers; even if they already have internal billing staff or scheduling software, Paradigm can take over claims processing as a specialized, expert billing department.
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Altair
Insurance companies run AI to review, adjust, and deny claims. Most practices still work them by hand. Altair closes that gap: an AI-native, done-for-you medical billing service that runs your full revenue cycle, from eligibility and prior authorization to claims, denials, and appeals, backed by a US-based team of expert billers. It is a service that does the work, not software your staff operates.
Altair scrubs claims against payer edits and medical-necessity policies, works denials to root cause, files appeals, and learns how each payer behaves. It also runs patient billing and collections for you: statements, payment reminders, payment plans, follow-up on unpaid balances, and aged patient A/R, so the patient share is collected in full. Coding and charge capture stay with your practice; Altair runs everything else. It works with every EHR, and a live view shows what is billed, paid, and at risk.
Payers built their AI to pay you less. Altair gets you paid in full.
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