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features
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support

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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.

Description

eClaimStatus offers a straightforward, practical, and efficient real-time system for Medical Insurance Eligibility Verification and Claim Status solutions that enhance healthcare delivery environments. As healthcare insurance providers continue to lower reimbursement rates, it becomes essential for medical professionals to keep a close eye on their revenue streams and minimize any potential loss and payment risks. The issue of inaccurate insurance eligibility verification is responsible for over 75% of claim denials and rejections from payers. Additionally, the costs associated with re-filing rejected claims can reach between $50,000 to $250,000 in lost annual net revenue for each 1% of claims that are denied (according to HFMA.org). To address these financial challenges, it is crucial to have a user-friendly, budget-friendly, and efficient Health Insurance Verification and Claim Status software. eClaimStatus was specifically developed to tackle these pressing issues and improve overall financial performance for healthcare providers. With its comprehensive features, eClaimStatus aims to streamline the verification process, ultimately enhancing the efficiency and profitability of healthcare practices.

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

No price information available.
Free Trial No 
Free Version No 

Pricing Details

No price information available.
Free Trial Yes 
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) Yes 
Online Support No 

Types of Training

Training Docs Yes 
Webinars No 
Live Training (Online) No 
In Person No 

Types of Training

Training Docs No 
Webinars No 
Live Training (Online) Yes 
In Person No 

Vendor Details

Company Name

PCG Software

Founded

1984

Country

United States

Website

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

Vendor Details

Company Name

eClaimStatus

Founded

2015

Country

United States

Website

eclaimstatus.com

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 

Product Features

Medical Billing

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

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