Audience

Healthcare organizations that want to enhance their current claims adjudication system

About 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.

Integrations

No integrations listed.

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Company Information

PCG Software
Founded: 1984
United States
pcgsoftware.com/product-offerings/virtual-examiner/

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Product Details

Platforms Supported
Cloud
Training
Documentation
Support
Phone Support
Online

Virtual Examiner Frequently Asked Questions

Q: What kinds of users and organization types does Virtual Examiner work with?
Q: What languages does Virtual Examiner support in their product?
Q: What kind of support options does Virtual Examiner offer?
Q: What type of training does Virtual Examiner provide?

Virtual Examiner Product Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Medical Billing

Claims Processing
Claims Scrubbing
Code & Charge Entry
Compliance Tracking
Customizable Dashboard
Dunning Management
Invoice History
Patient Eligibility Checks
Practice Management
Quotes/Estimates
Remittance Advice