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Description
An effective claims management software solution is designed to efficiently handle claims, complaints, and customer service inquiries. It facilitates rapid claims settlement, minimizes per-claim costs, and enables effective management of claim volumes through features like trend analysis, fraud detection, and insightful reporting. With cloud-based accessibility, it serves as a centralized hub for real-time information sharing and actionable insights. The integrated report generator allows users to create customized ad-hoc reports while providing advanced management information through heatmaps, dashboards, and trend assessments. Our system is built without limitations, ensuring seamless integration with any existing back-office solutions you may have. Utilizing Microsoft-based enterprise technology, it adapts to your business's growth and needs. Reduced onboarding time allows your team to start working efficiently from day one. Furthermore, it equips managers with automated, up-to-the-minute reporting capabilities. The platform also simplifies the integration process for legacy systems and accommodates various technological requirements. With expertise spanning multiple sectors, it enhances the ease of discovery, development, and integration for diverse business needs, ensuring a comprehensive solution for your organization.
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
Integrations
DWF 360
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
DWF Group
Founded
1977
Country
United Kingdom
Website
dwfgroup.com/en/services/dwf-360/evoclaim
Vendor Details
Company Name
PCG Software
Founded
1984
Country
United States
Website
pcgsoftware.com/product-offerings/virtual-examiner/
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
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