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Average Ratings 0 Ratings

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features
design
support

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Write a Review

Description

Get alerts whenever payors adjust their policies, as staying updated is crucial. Rather than sifting through countless pages of complex insurance terminology, our software identifies policy modifications and creates clear, concise notes for your billing and coding teams to use effectively. You can swiftly access policy details relevant to specific claim dates and leverage our data to strengthen your case outcomes. This streamlined approach not only saves time but also enhances your team's efficiency and effectiveness in navigating policy changes.

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 

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

$199 per user per month
Free Trial Yes 
Free Version Yes 

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 Yes 
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

Compliance PT

Founded

2014

Country

United States

Website

compliancept.com

Vendor Details

Company Name

PCG Software

Founded

1984

Country

United States

Website

pcgsoftware.com/product-offerings/virtual-examiner/

Product Features

Medical Billing

Claims Processing No 
Claims Scrubbing No 
Code & Charge Entry Yes 
Compliance Tracking No 
Customizable Dashboard No 
Dunning Management Yes 
Invoice History No 
Patient Eligibility Checks No 
Practice Management Yes 
Quotes/Estimates No 
Remittance Advice Yes 

Policy Management

Approval Process Control Yes 
Attestation Yes 
Audit Trails Yes 
Policy Creation No 
Policy Library No 
Policy Metadata Management Yes 
Policy Training Yes 
Reporting / Analytics Yes 
Version Control Yes 
Workflow Management Yes 

Revenue Management

Competitor Analysis No 
Dynamic Pricing No 
For Airlines No 
For Hospitality Industry No 
Forecasting Yes 
Inventory Control No 
Price Optimization Yes 
Recommendation Engine Yes 
Yield Management Yes 

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 

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