Service Center
Service Center by Office Ally is trusted by more than 80,000 healthcare providers and health services organizations to help them take complete control of their revenue cycle. Service Center can verify patient eligibility and benefits, submit, correct, and check claims status online, and receive remittance advice. Accepting standard ANSI formats, data entry, and pipe-delimited formats, Service Center helps streamline administrative tasks and create more efficient workflows for providers.
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Macaw AMS
Macaw AMS can be used to sell Insurance. Macaw AMS can be used by brokers, MGAs or MGUs, Program Managers, and Lloyds Coverholders to automate their operations.
Macaw AMS was built with a customer-centric approach. It supports CRM, Sales and Underwriting. Customers, producers, and service providers can access self-service portals.
Macaw AMS has built-in Document Management and Task Management capabilities. It is equipped with adaptors that allow for integrated and in-flow services such as eSignature, Payments, OFAC checks, Mass Emailing, Computer Telephony, and Mass Emailing, using 3rd Party Services.
The data analytics part of Macaw AMS offers powerful data visualization with predefined dashboards, allowing users to easily upload datasets and view dynamic charts for clear, multi-dimensional insights. Interactive, real-time visualizations help uncover trends and insights, driving informed decision-making.
Macaw AMS is hosted on cloud and tested for cybersecurity. The database is relational, and the core components of the Java-based application are written in Java. Macaw AMS is capable of processing 500-1000 policies per day at its peak.
Macaw AMS is expected reduce per policy costs by 30%.
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Alaffia
Alaffia utilizes an advanced AI-driven system to identify and address fraud, waste, and abuse within complex healthcare claims, aiming to avert and recuperate overpayments for both payers and employers. By spotting and rectifying inaccuracies in misbilled claims prior to any incorrect payments being processed, Alaffia not only helps recover funds but also aids in minimizing future financial losses. With the potential for overpayments on erroneous claims to amount to hundreds of dollars annually for each employee, collaborating with Alaffia can lead to significant cost savings. The Alaffia system works to identify and amend incorrectly billed claims, thereby reducing the chances of overpayments occurring. Our integration with your health plan or TPA is designed to be seamless, ensuring that there is no interruption in service for your members. We operate on a contingency basis, meaning you incur costs only when we successfully generate savings for you. Additionally, we take measures to guarantee that providers do not bill your employees for services that were never actually rendered, thus safeguarding your financial interests. Through our innovative approach, we strive to enhance the overall integrity of healthcare billing practices.
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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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