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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 ClaimPilot?

ClaimPilot offers a remarkable online solution for claims management, paired with exceptional customer support. Designed specifically for professionals in the claims management sector who are looking to enhance and streamline their operations, ClaimPilot provides an intuitive interface that includes key features and functionalities to improve the oversight of claims and financial information through customizable reporting tools. This platform meets the increasing needs for data entry with its versatile capabilities, resulting in improved efficiency in the processing of claims. Unlike traditional risk management software that can be cumbersome or basic systems that focus solely on document management, ClaimPilot integrates all the essential elements for thorough claims management, ensuring compliance with Lloyd’s standards and incorporating workers' compensation features. Additionally, our dedicated customer service team works closely with clients to develop tailored reports and functionalities that adapt to their changing requirements. We strongly believe that the growth of your organization is intertwined with our own, and our commitment lies in facilitating your success and development. By choosing ClaimPilot, you are not just selecting a software solution; you are partnering with a team that prioritizes your needs.

Media

Media

Integrations Supported

Additional information not provided

Integrations Supported

Additional information not provided

API Availability

API Availability

Pricing Information

Pricing not provided

Pricing Information

Pricing not provided
Free Trial Offered?

Supported Platforms

SaaS

Supported Platforms

SaaS
Android
iPhone
iPad

Customer Service / Support

Standard Support
Web-Based Support

Customer Service / Support

Standard Support
Web-Based Support

Training Options

Documentation Hub

Training Options

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

Quick Internet

Date Founded

2000

Company Location

United States

Company Website

claimpilot.com

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

Medical Coding

Not specified

Categories and Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Compliance Management
Electronic Claims
Forms Management
Payor Management
Policy Administration

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