Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
EncoderPro Spotlight, developed by OptumCoding, is an online medical coding reference tool specifically crafted to assist professionals involved in ambulatory coding, billing, and reimbursement by providing them with timely and precise access to various code sets including CPT, HCPCS Level II, ICD-10-CM/PCS, and ICD-9-CM, as well as relevant regulatory guidance; this software boasts robust search and reference functionalities that integrate numerous procedure, service, supply, and diagnosis codes along with detailed descriptive and cross-coding data, allowing users to swiftly identify the appropriate codes and minimize submission errors. In addition to fundamental code listings, it also offers unique content and tools that enrich users' understanding of compliance issues, addressing topics such as National Correct Coding Initiative (NCCI) edits, Hierarchical Condition Categories (HCCs), and policies regarding coverage determinations, while featuring automated review options for correct unbundling and modifier application, alongside a comprehensive historical content database for adjudication purposes. This makes EncoderPro Spotlight an invaluable resource for coding professionals seeking to enhance their accuracy and efficiency in the complex landscape of medical coding.
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
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
Optum
Country
United States
Website
www.optumcoding.com/online-coding/encoderpro-spotlight/
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
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