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.
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Integrations
No integrations listed.
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
Virtual Examiner Product Features
Claims Processing
Adjustor Management
Supported
Case Management
Supported
Claim Resolution Tracking
Supported
Co-Pay & Deductible Tracking
Supported
Compliance Management
Supported
Customer Management
Supported
Electronic Claims
Supported
Forms Management
Supported
Paper-Based Claims
Supported
Payor Management
Supported
Policy Administration
Supported
Medical Billing
Claims Processing
Supported
Claims Scrubbing
Supported
Code & Charge Entry
Supported
Compliance Tracking
Supported
Customizable Dashboard
Supported
Dunning Management
Supported
Invoice History
Supported
Patient Eligibility Checks
Supported
Practice Management
Supported
Quotes/Estimates
Supported
Remittance Advice
Supported
