SpyGlass
SpyGlass, our enterprise-class software for managing health claims, is a powerful and flexible solution that allows for fast and accurate claims processing. SpyGlass makes it easy to set up benefits and plans. BenefitDriven is fully integrated with SpyGlass and provides eligibility, contribution accounting, pension management, and payroll management to the Taft-Hartley sector with all the data and processes for Participants as well as Employers. HIPAA Director, our all in one EDI gateway & scheduler acts as a hub, allowing you to connect with vendor partners to help reduce transaction costs, manage batch transfer, and automate transfers. SpyGlass gives you a detailed, panoramic view of your population. You can drill down to more detail. You have access to hundreds of reports, fully customizable dashboards and total control over the system.
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MediClaims
WLT's MediClaims program offers a cost-effective and straightforward approach to benefits and claims administration. WLT's integrated EDI processes and rules-based architecture allow for claims to be processed quickly and accurately. MediClaims offers a wide range of benefits and claim types, including Prescription Drugs, Vision, Medical, Dental, Vision, Prescription Drugs, Consumer-Driven Healthcare, Disability, Capitation processing, as well as processing capabilities. WLT's MediClaims system allows you to set up your groups for a single or multiple lines of coverage. Without reliable information systems, no plan can function efficiently. WLT is committed to using the most modern technologies available, providing you with the most flexible and sophisticated systems possible.
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KMR Medical Claims Manager
KMR Claims Processing manager is a state of the art, fully integrated, customizable, claims processing solution for TPAs and Self-Insured. Our system allows for electronic claims, integrates seamlessly with Document Imaging systems, can process debit cards, and is fully HIPAA compliant.
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Virtual Examiner
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.
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