Altair
Insurance companies run AI to review, adjust, and deny claims. Most practices still work them by hand. Altair closes that gap: an AI-native, done-for-you medical billing service that runs your full revenue cycle, from eligibility and prior authorization to claims, denials, and appeals, backed by a US-based team of expert billers. It is a service that does the work, not software your staff operates.
Altair scrubs claims against payer edits and medical-necessity policies, works denials to root cause, files appeals, and learns how each payer behaves. It also runs patient billing and collections for you: statements, payment reminders, payment plans, follow-up on unpaid balances, and aged patient A/R, so the patient share is collected in full. Coding and charge capture stay with your practice; Altair runs everything else. It works with every EHR, and a live view shows what is billed, paid, and at risk.
Payers built their AI to pay you less. Altair gets you paid in full.
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AltuMED PracticeFit
Conducting thorough checks on the financial eligibility of the patients, running their insurance’s analysis and monitoring discrepancies, the eligibility checker covers all. If however any error does creeps in the data submitted, our scrubber working on deep AI&ML algorithms is capable of scrubbing errors be it coding errors, incomplete or wrong patient financial information. The software, at present, has 3.5 Million edits pre-loaded in its memory. To further streamline the process, automatic updates are issued by the clearing house to inform about the status of in-process claims. Covering the entire billing spectrum from verifying the patient financials to working on denied or lost claims and also has a through follow-up feature for appeals. Our intuitive systems warns if a claim could be denied, taking corrective actions to prevent it but also is capable of tracking and appealing for lost or denied claims.
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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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Healthicity Audit Manager
For medical auditing, Audit Manager streamlines the way you manage audits by merging audit workflow, management, education, and reporting into one easy-to-use, web-based solution.
Audit Manager brings simplicity by helping you:
Identify Revenue
Evaluate financial impact. Minimize denials and identify up to 10%, per provider, in missed revenue with extensive reporting and analytics tools.
Increase Efficiency
Improve your auditing efficiency by up to 40%. Reduce the amount of time you spend completing audits with our user-friendly interface.
Improve Accuracy
Customize your audit templates. Include your own standards, MAC carrier guidelines, and claim scrubber tech for ideal results.
Audit Manager features:
Built-in Tableau integration for in-depth analytics and reporting.
Flexible Audit Management: View the status, and each associated status, of every audit, by any auditor.
E/M Calculator
Automatically calculate E/M codes with a built-in calculator.
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