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What is Virtual Examiner?

The Virtual Examiner®, developed by PCG Software, serves as a comprehensive tool for overseeing an organization’s internal claims process, efficiently tracking provider data to identify fraudulent or abusive billing practices while enhancing financial recovery. This advanced software enables healthcare organizations to optimize their claims adjudication systems, processing over 31 million edits per claim, which significantly streamlines operations. By meticulously monitoring the internal claims processes, it effectively pinpoints and mitigates payments made for incorrect or erroneous codes, ultimately preserving premium dollars. Beyond mere claims management, the Virtual Examiner® acts as a robust cost containment solution that analyzes claims for not only abusive billing patterns but also those that may require attention to third-party liability coordination, case management opportunities, physician billing education, and various other valuable cost recovery insights. Its multifaceted approach provides healthcare organizations with the tools they need to navigate complex billing landscapes and improve overall financial health.

What is CEASE.ai?

A groundbreaking artificial intelligence system has been introduced to more effectively identify and address child sexual abuse material, with the goal of safeguarding victims more rapidly. By utilizing actual CSAM data, this AI adeptly scans, identifies, and flags new images that portray child exploitation with impressive accuracy. Collaborating with law enforcement agencies and leading Canadian universities, CEASE.ai harnesses a mix of neural networks and diverse AI models to ensure precise detection of such harmful material. The system provides investigators with an intuitive plugin that enables them to upload images from ongoing cases and utilize hash lists to exclude known content. Following this, the AI proposes possible labels and prioritizes images that could contain previously unrecognized CSAM. Investigators are then able to review the flagged images, confirm their illicit nature, bolster their cases against offenders, and hasten the rescue of at-risk victims. Moreover, social media platforms connect with the CEASE.ai API endpoint, allowing for the real-time processing of all user-uploaded images, which ensures that any content associated with child abuse is quickly identified and classified. This innovative methodology not only improves the efficiency of investigations but also plays a vital role in the ongoing effort to protect vulnerable children, ultimately contributing to a safer online environment for all.

Media

Media

Integrations Supported

Additional information not provided

Integrations Supported

Additional information not provided

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

PCG Software

Date Founded

1984

Company Location

United States

Company Website

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

Company Facts

Organization Name

Two Hat

Date Founded

2012

Company Location

Canada

Company Website

www.twohat.com/cease-ai/

Categories and 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

Categories and Features

Content Moderation

Artificial Intelligence
Audio Moderation
Brand Moderation
Comment Moderation
Customizable Filters
Image Moderation
Moderation by Humans
Reporting / Analytics
Social Media Moderation
User-Generated Content (UGC) Moderation
Video Moderation

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