ARIA Coding Services
ARIA Coding Services is designed to assist healthcare providers in navigating the complexities of medical coding, ensuring accurate documentation and timely reimbursements. The service offers three customizable levels to meet varying practice needs. Experts conduct monthly reviews of coding denials and rejections, providing recommendations to improve standard operating procedures and offering optional baseline evaluations of Evaluation and Management (E&M) documentation. Specialists review documentation to confirm coding accuracy, examining superbills, invoices, claims, E&M visits, surgeries, procedures, tests, modifiers, and ICD-10 usage. They deliver regular reports and address discrepancies to enhance coding procedures. A comprehensive service where specialists handle coding directly from provided documentation, ensuring proper entry of charges, thorough documentation in patient notes, and correction of coding rejections or denials as needed.
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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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Context 4 Health Plans Suite
Protect the integrity of your health plan and determine accurate pricing with the Context4 Health Plans Suite, our modular, cloud‑based technology platform. Immediate, actionable, and defensible Fraud, Waste, and Abuse (FWA) detection built by our team of certified clinical, dental, and health benefits experts. Accurate data and cutting-edge cloud technology combine to create a proven and defensible medicare reference-based pricing (RBP) solution. More than 100 healthcare data sets, with professional support to optimize efficiency and compliance. Advanced medical coding software designed to expedite claim submission and minimize denials. Our cloud based Payment Integrity Platform utilizes our proprietary analytics engine to identify coding errors, medical necessity, unbundling, fraud-waste-abuse, audit risks, pricing and other aberrations that can impact your business.
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Encipher Health
Encipher Health is a comprehensive AI-powered healthcare technology platform that automates medical coding, risk adjustment, and revenue-cycle processes across specialties. Using Neuro-Symbolic AI, OCR, ML, and knowledge-graph logic, it converts unstructured clinical documentation into accurate, audit-ready codes (CPT, ICD-10, HCC, HCPCS) while enforcing payer, CMS and compliance rules. Its products — including GI coding automation, radiology coding (Conrad AI), anesthesia coding (Sedate AI), HCC/risk adjustment (Cogent AI / RiskGen‑Core / RAF Totalizer), E/M coding, home-health coding, ICD-10-AM support, AR follow-up and denial resolution — streamline workflows, reduce manual effort, minimize denial risk, and accelerate reimbursements. Real-time and retrospective workflows, seamless EHR integration, MEAT-criteria validation, modifier logic, and compliance guardrails ensure high accuracy, regulatory alignment and audit readiness.
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