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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 RapidClaims?

Minimize administrative costs while simultaneously boosting reimbursement rates, all while strictly adhering to compliance standards. Revolutionize your revenue cycle management (RCM) through the cutting-edge features of RapidClaims, driven by AI technology. Dramatically lower administrative expenses, increase reimbursement levels, and ensure compliance with ease. Streamline your coding processes by automating tasks or providing your coding team with customized solutions tailored to your unique requirements. Efficiently process thousands of charts with speed and precision, addressing the specific needs of every client. Our sophisticated language model expertly manages unstructured data, creating a detailed patient record by converting notes into organized codes and detecting disease patterns. Prevent the recurrence of previous mistakes by setting comprehensive coding rules in clear language, easily applicable across various charts, categorized by specialty, code type, and individual coders. Gain deeper insights into code-level trends across different locations and take proactive measures to optimize the revenue cycle. Moreover, our platform thoroughly examines charts to identify patterns in claim denials, equipping you with effective tools to tackle these issues and enhance overall performance. By leveraging these advanced capabilities, you can create a more efficient and effective coding process that not only supports your organization's financial stability but also fosters long-term growth and sustainability.

Media

Media

Integrations Supported

Better
DrChrono
EPIC HRMS
Elation Health
Google Cloud Platform
HCS Connect
MEDITECH Expanse
Microsoft 365
NEON
Together AI
athenaOne
eClinicalWorks
eMedicalPractice

Integrations Supported

Better
DrChrono
EPIC HRMS
Elation Health
Google Cloud Platform
HCS Connect
MEDITECH Expanse
Microsoft 365
NEON
Together AI
athenaOne
eClinicalWorks
eMedicalPractice

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

RapidClaims

Company Location

United States

Company Website

www.rapidclaims.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

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