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ease
features
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features
design
support

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Description

Centauri Health Solutions is a company specializing in healthcare technology and services, motivated by our commitment to enhance the efficiency of the healthcare system for our clients while offering compassionate assistance to those in need. Our software, powered by advanced analytics, supports hospitals and health plans—including Medicare, Medicaid, Exchange, and Commercial sectors—in effectively managing their fluctuating revenue through a bespoke workflow platform. Moreover, our personalized support for patients and members grants them access to vital benefits that can significantly improve their quality of life. Our array of solutions encompasses Risk Adjustment (including Medical Record Retrieval, Medical Record Coding, Analytics, and RAPS/EDPS Submissions), management of HEDIS® and Stars Quality Programs, Clinical Data Exchange, Eligibility and Enrollment services, Out-of-State Medicaid Account Management, Revenue Cycle Analytics, and both Referral Management & Analytics, as well as addressing Social Determinants of Health to further bolster healthcare outcomes and accessibility. Each of these components is designed to work in harmony, ultimately creating a more effective and compassionate healthcare experience for everyone involved.

Description

Utilize a cloud-based healthcare delivery system to effectively manage your members' healthcare and networks. This system streamlines the claims processing for managed care organizations by automating various tasks such as eligibility verification, referral and authorization handling, provider contracting, benefit management, auto adjudication of claims, capitation for primary care and specialty services, EOB/EFT check processing, as well as EDI transfers and reporting. It can be implemented as a cloud solution or operated in-house, making it suitable for a range of entities including managed care organizations (MCOs), independent physician associations (IPAs), third-party administrators (TPAs), preferred provider organizations (PPOs), and self-insured groups. By simplifying the intricate processes involved in managing eligibility, referral authorizations, and claims, this system enhances operational efficiency. Its features are designed to optimize data integrity while minimizing the need for manual data entry, thus improving overall accuracy and productivity. Additionally, the flexibility of deployment options ensures that organizations can choose the best fit for their operational needs.

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

API Access

Has API

Screenshots View All

Screenshots View All

Screenshots View All

Integrations

No details available.

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

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

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

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

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

Centauri Health Solutions

Founded

2014

Country

United States

Website

www.centaurihs.com

Vendor Details

Company Name

Imagine Software

Founded

2000

Country

United States

Website

www.imagineteam.com

Vendor Details

Company Name

PCG Software

Founded

1984

Country

United States

Website

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

Product Features

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

Revenue Cycle Management

Accounts Receivable
Claims Management
Collections Management
EHR/EMR Integration
For Healthcare
ICD-10 Compliance
Insurance Verification
Medical Billing
Patient Portal
Patient Registration
Patient Scheduling
Payment Processing

Product Features

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

Revenue Cycle Management

Accounts Receivable
Claims Management
Collections Management
EHR/EMR Integration
For Healthcare
ICD-10 Compliance
Insurance Verification
Medical Billing
Patient Portal
Patient Registration
Patient Scheduling
Payment Processing

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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