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Ratings and Reviews 0 Ratings
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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 FBCS Enterprise?
FBCS Enterprise acts as a unified platform that improves decision-making for non-VA Purchased care, resulting in more effective management and processing of fee basis claims. The web-based tool, CTM Plus, refines workflows and delivers essential oversight to tackle problems related to consults and Return to Clinic (RTC) tracking, thereby ensuring timely communication with patients and efficient scheduling. Furthermore, purchasing analytics are vital in reducing expenses and eliminating waste, which enhances accountability across the healthcare system. The automated tracking of expired and recalled items is a significant factor in maintaining patient safety. Delays or mistakes in order fulfillment can negatively impact financial outcomes and the standard of care received. The time devoted to managing paper records and digital interfaces limits crucial patient interactions, while the verification of opioid prescriptions for each patient can be an arduous and complex task. DSS PDMP alleviates this burden by merging all required checks into a single, uncomplicated process, thus improving patient care efficiency. This comprehensive strategy for managing care not only streamlines operations but also leads to enhanced health outcomes for patients, ultimately fostering a more responsive and effective healthcare environment. By focusing on these efficiencies, the system can allocate more resources toward direct patient engagement, which is essential for improving overall care quality.
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
DSS
Date Founded
1991
Company Location
United States
Company Website
www.dssinc.com/federal-health
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
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