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ease
features
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support

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Description

Founded in 2000, DataGenix is dedicated to delivering innovative claims processing solutions to third-party administrators, adjusters, and insurance firms. Recognizing the complexities that can arise in claims processing and health benefits management, our team has developed the sophisticated ClaimScape software designed to streamline the entire adjudication process, ensuring your business remains unaffected by potential losses. Our mission is to tackle the challenges that prevent an exceptional customer experience for your clientele. By aligning our offerings with current trends and demands, we are committed to facilitating your organization's growth through our software solutions. Trusted by leading TPAs nationwide, we are eager to expand our services to a broader audience. As we continue to evolve, we aim to set new standards in the industry.

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

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

DataGenix

Founded

2003

Country

United States

Website

datagenix.com

Vendor Details

Company Name

PCG Software

Founded

1984

Country

United States

Website

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

Product Features

Benefits Administration

COBRA Administration
Claims Management
Deduction Management
Disability Insurance Administration
Employee Benefits Administration
FMLA Administration
FSA Administration
Flexible Spending Accounts
For Brokers
For Employers
HIPAA Compliant
Health Insurance Administration
Life Insurance Administration
Online Benefits Enrollment
Premium Billing
Provider Management
Retiree Administration
Retirement Plan Management

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Product Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Medical Billing

Claims Processing
Claims Scrubbing
Code & Charge Entry
Compliance Tracking
Customizable Dashboard
Dunning Management
Invoice History
Patient Eligibility Checks
Practice Management
Quotes/Estimates
Remittance Advice

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