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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expEDIum Medical Billing
A secure, SaaS-based Medical Billing, RCM software that helps doctors to increase the collection, and receive faster payment with improved automation. Features like Seamless Insurance Eligibility Verification (IEV), Appointment scheduling, Claims scrubbing, Claim Status Inquiry (CSI),Auto Posting, and Public health clinic make the software efficient and easy to use. expEDIum SDK is available with several APIs to integrate EMR software seamlessly with expEDIum Medical Billing / RCM software.
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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: AI-native medical billing that runs your full revenue cycle, from eligibility and prior auth to claims, denials, and appeals, backed by a US-based team of expert billers.
Altair scrubs claims against payer edits and medical-necessity rules before they go out, works denials to root cause, and files appeals. It learns how your payers behave, so first-pass acceptance and net collection rate climb the longer you use it. A live view shows what's billed, in flight, paid, and at risk.
It runs alongside your existing EHR, with onboarding in hours. Independent practices, medical groups, and billing companies get the billing firepower of a large organization without hiring an army.
Payers built their AI to pay you less. Altair gets you paid in full.
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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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