iVEcoder

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.

Access the highest quality data and intelligence on hospitals, physicians, and other healthcare providers - updated daily. We help companies across the healthcare ecosystem grow their businesses and create new paths to commercial success. Here are just a few reasons why we’ve been a leader in healthcare commercial intelligence for 10 years and counting. Fueled by powerful data science and AI, we have intelligence for all your commercial needs. Healthcare commercial intelligence untangles the web of data on delivery systems, physicians, payor, patients, government organizations and more to identify the people, opportunities and organizations that are the best fit for your product. Building and selling a product for the healthcare market is complex. Answers to critical questions are often buried in disparate information systems, making centralized insights hard to come by. Healthcare commercial intelligence (HCI) is a new category of software that untangles the web of data on delivery.