Us4U Reviews

Guidewire ClaimCenter, a leading claims-management system, is designed to streamline all aspects of the claims lifecycle. It provides comprehensive functionality, from the initial claim intake through to resolution. This allows insurers to process their claims efficiently and accurately. The key features include automated workflows and embedded analytics, integrated Fraud detection, and real time performance monitoring. These all improve operational efficiency and customer satisfaction. ClaimCenter is compatible with a variety of insurance lines, including personal, workers' compensation, commercial and business. It can be used as a standalone application or as part the Guidewire InsuranceSuite. ClaimCenter allows insurers to accelerate claim processing, make data driven decisions, and adapt their business to changing market demands.

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.