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ease
features
design
support

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Description

Doctors enter the medical profession without the intention of mastering coding practices. We are revolutionizing the revenue cycle's future through autonomous coding driven by artificial intelligence. Our platform is currently utilized by over a dozen leading healthcare organizations and systems, encompassing more than 200 hospitals and 50,000 healthcare providers. CodaMetrix’s advanced coding AI system effectively converts clinical data into precise medical codes essential for patient care and the revenue cycle, accommodating both fee-for-service and value-based care frameworks. The automation process is seamless, transparent, and fully traceable. By utilizing CodaMetrix's innovative, multi-specialty autonomous medical coding platform, we harness AI to continuously analyze and utilize clinical evidence found in electronic health records. Our system autonomously converts clinical notes into billing codes that fulfill coding standards, ensuring that claims accurately reflect the intricate and comprehensive nature of each patient’s care episode, significantly alleviating the burden on human coders while enhancing efficiency. As a result, healthcare providers can focus more on patient care instead of administrative tasks.

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

CodaMetrix

Country

United States

Website

www.codametrix.com

Vendor Details

Company Name

PCG Software

Founded

1984

Country

United States

Website

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

Product Features

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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