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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 OHIPay?

OHIPay is a cloud-based medical billing platform tailored for physicians and their billing teams in Ontario. It features a web-based interface and a mobile app that empowers users to create claims using health-card details, verify patient eligibility, apply fee codes, calculate relevant premiums, and receive advisory alerts regarding potential rejection codes. Users can group claims for submission through MC EDT and track their status from the draft phase to final submission, payment, or rejection. Furthermore, OHIPay supports inpatient rounding rosters, facilitates health-card scanning, and provides correction and resubmission capabilities while allowing reconciliation of Ministry remittance reports with submitted services. The platform also includes useful references for billing codes. While the software aims to assist practices in managing their Ontario physician claims effectively, the advisory warnings provided are meant solely for review and do not ensure acceptance or payment of claims. In essence, OHIPay not only simplifies the billing process but also significantly boosts operational efficiency for healthcare providers in Ontario, making it an invaluable tool for medical practices.

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

$20/physician/month
$0 for the first 6 months, then $20/month plus HST per physician from month 7. Billing staff and the phone app are included. No setup fee or contract; month-to-month, cancel any time.
Free Trial Offered?

Supported Platforms

SaaS

Supported Platforms

SaaS
Android
iPhone

Customer Service / Support

Standard Support
Web-Based Support

Customer Service / Support

Standard Support
Web-Based Support

Training Options

Documentation Hub

Training Options

Documentation Hub
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

Medinote Technologies Inc.

Date Founded

2026

Company Location

Canada

Company Website

ohipay.ca

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

Medical Billing

Not specified

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