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Description
At the heart of PBM Express lies the adjudication program, where claims undergo extensive edits to ensure precise processing outcomes, no matter how complex the plan design may be. The parameter drive program supports a highly adaptable framework that facilitates client-specific customization as required. Laker's cutting-edge software solution equips clients with exceptional performance and top-notch uptime that leads the industry. As a frontrunner in technology, Laker consistently upgrades and improves its systems to address the evolving demands of its clientele. Customers of Laker benefit from having access to the fastest, most versatile, and most resilient system in the market. Furthermore, Laker collaborates closely with its clients to conceive, test, and roll out new products, empowering them to enhance their competitive edge and secure new business opportunities. As client claim volumes increase, Laker evolves alongside them, underscoring the mutual benefit for both parties in implementing prompt and efficient software changes to support this growth. This commitment ensures that Laker remains a valuable partner in its customers' success.
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
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
Laker Software
Founded
2000
Country
United States
Website
www.lakersoftware.com/services
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