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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Duck Creek Claims
Duck Creek Claims is a comprehensive claims management solution designed to streamline the entire claims lifecycle for insurers. From the initial report to final settlement, it automates workflows, simplifies data analysis through integrated analytics, and ensures seamless integration with existing systems. Key features include dynamic first notice of loss (FNOL) capabilities, automated assignment based on adjuster skills and workload, instant access to policy and coverage data, and efficient adjuster workflows. By enhancing operational efficiency and reducing manual workloads, Duck Creek Claims enables faster claims resolution, improved customer satisfaction, and compliance with the latest regulations.
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Cloud Claims
Improve claim outcomes with streamlined First Notice of Loss (FNOL), claim processing and flexible reporting.
INCIDENT BASED CLAIMS MANAGEMENT
Effective claims management is about more than simply managing claims outcomes. It is about having an automated process that ensures efficiency and accuracy across the organization, getting timely notice of losses, and taking swift action are keys to success. The incident-based approach of Cloud Claims covers all accidents and losses, delivering a complete picture of loss to executives and claims managers.
Cloud Claims by APP Tech is an integrated solution that is highly configurable, with actionable reports to guide decision-making and a friendly UI so you can get work done faster and more confidently.
Cloud Claims runs in the cloud, so there’s minimal IT burden and no installation required — just simple configuration, effortless system upgrades, best-in-class security, and the ability to scale quickly.
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MarvelX AI
MarvelX builds agentic AI for financial services and highly regulated industries, starting with AI claims agents for insurance. The platform handles autonomous claims processing at high volume, from first notice of loss (FNOL) through policy validation, adjudication, and settlement, so insurers cut claims handling time from days to under an hour. Built for P&C, motor, travel, health, life, and embedded insurers, plus MGAs and TPAs, MarvelX validates policy details, checks document completeness, and routes edge cases to human reviewers, keeping a human in the loop with audit-ready output. It also offers AI document data extraction for insurance: structured fields from documents, each with a source reference. Beyond insurance, MarvelX is extending the same agent architecture to other regulated workflows, such as KYC/KYB verification for notarial services. MarvelX connects to the systems teams already run, including HubSpot and Dutch registries (KVK, RDW, SchadeGarant).
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