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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 LMS Suite?

The Loan Management System (LMS) streamlines the trading and oversight of residential whole loans, enabling users to manage the entire loan pipeline effectively. It supports the management of third-party evaluations and automates funding and settlement processes for efficiency. Sellers can easily lock and price loans, either on a flow or bulk basis, while ensuring compliance with the eligibility requirements through an intuitive portal. They also have the capability to upload essential credit documents and fulfill any conditions that emerge during the review phases. Documents are securely stored at various levels, including trade, pool, and individual loans, enhancing security and organization. The system facilitates document exchanges with third-party vendors via secure integrations, allowing for seamless collaboration. Orders can be assigned to the correct due diligence vendors based on specific product criteria and transaction volume, providing a customized solution for each seller. Users are able to view and respond to findings from third-party reviewers through automated data feeds, ensuring timely updates. Additionally, the LMS generates detailed funding schedules that outline amortized balances, interest, and fees, which boosts the overall efficiency and accuracy of the loan management process. This integrated approach not only optimizes operations but also significantly minimizes the likelihood of errors, ultimately improving the reliability of the loan management framework. By enhancing communication and documentation practices, the system fosters a more transparent and accountable lending environment.

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

Supported Platforms

SaaS

Supported Platforms

SaaS

Customer Service / Support

Standard Support
Web-Based Support

Customer Service / Support

Standard Support
Web-Based Support

Training Options

Documentation Hub

Training Options

Online 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

Street Solutions

Company Website

www.streetsolutions.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

Claim Resolution Tracking

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