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Average Ratings 0 Ratings
Description
EMCsoft's Claims Management Ecosystem guarantees that healthcare providers and billing companies submit accurate claims to insurance payers for effective claim processing. This system combines our adaptable claims processing software, Claim Agent, with a comprehensive methodology known as the Four Step Methodology, seamlessly integrating into your claim adjudication workflow. By implementing this strategy, we enhance, facilitate, and automate your processes to optimize claim reimbursements. For an insightful overview of Claim Agent's features and its integration into your claims process, you can request our complimentary online demonstration. Claim Agent efficiently manages the scrubbing and processing of claims, ensuring a smooth transition from provider systems to insurance payers in a timely and cost-effective manner. The software is designed to be compatible with any existing system, ensuring a swift and straightforward implementation. Furthermore, we offer tailored edits, bridge routines, payer lists, and workflow configurations that cater specifically to each user's requirements, enhancing the overall claims management experience. This personalized approach enables healthcare providers to focus more on patient care while we take care of the complexities of claims processing.
Description
Virtual Examiner®, PCG Software’s flagship product, monitors an organization's internal claims process to track provider data for fraudulent or abusive billing patterns and maximizes financial recovery. The Virtual Examiner®, a PCG Software product, allows healthcare organizations to improve their claims adjudication system by allowing for more than 31,000,000 edits per claim. The software monitors an organization's internal claim process to identify and reduce payments for incorrect or erroneous code to save premium dollars. Virtual Examiner®, is more than a claims management solution that focuses 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.
API Access
Has API
No
API Access
Has API
No
Integrations
No details available.
Integrations
No details available.
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
Yes
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
Yes
Types of Training
Training Docs
No
Webinars
No
Live Training (Online)
Yes
In Person
No
Types of Training
Training Docs
Yes
Webinars
No
Live Training (Online)
No
In Person
No
Vendor Details
Company Name
EMCsoft
Founded
1980
Country
United States
Website
emcsoft.com
Vendor Details
Company Name
PCG Software
Founded
1984
Country
United States
Website
pcgsoftware.com/product-offerings/virtual-examiner/
Product Features
Long Term Care
Claims Management
Yes
Clinical Care
No
EHR
No
Electronic Health Record
No
For Home Care Providers
No
For Nursing Homes
No
Geriatric Care
No
MDS Review
No
Patient Records
No
Staff Scheduling
No
Medical Billing
Claims Processing
No
Claims Scrubbing
Yes
Code & Charge Entry
No
Compliance Tracking
Yes
Customizable Dashboard
Yes
Dunning Management
Yes
Invoice History
Yes
Patient Eligibility Checks
No
Practice Management
No
Quotes/Estimates
Yes
Remittance Advice
No
Product Features
Claims Processing
Adjustor Management
Yes
Case Management
Yes
Claim Resolution Tracking
Yes
Co-Pay & Deductible Tracking
Yes
Compliance Management
Yes
Customer Management
Yes
Electronic Claims
Yes
Forms Management
Yes
Paper-Based Claims
Yes
Payor Management
Yes
Policy Administration
Yes
Medical Billing
Claims Processing
Yes
Claims Scrubbing
Yes
Code & Charge Entry
Yes
Compliance Tracking
Yes
Customizable Dashboard
Yes
Dunning Management
Yes
Invoice History
Yes
Patient Eligibility Checks
Yes
Practice Management
Yes
Quotes/Estimates
Yes
Remittance Advice
Yes