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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 Stipulate?

Stipulate is a digital platform tailored for the assessment of commercial claims, allowing companies to evaluate overdue B2B accounts before taking collection or legal action. It examines account information against a variety of claim-relevant criteria, including statutes of limitations, jurisdictional aspects, recovery clauses, and classifications of debtors, ultimately delivering an outcome of accept, review, or reject along with pertinent citations. Users have the option to evaluate accounts individually or upload entire portfolios in CSV format for simultaneous assessments. The platform is recognized for its capability to match columns from aging export data, calculate deadlines based on the jurisdiction and type of claims, and keep a historical log of evaluations for each account. Furthermore, results can be downloaded in a scored spreadsheet format, facilitating the prioritization of accounts that need further investigation. Designed to boost efficiency and improve decision-making in the collections process, Stipulate empowers businesses to concentrate on accounts that need prompt attention. This user-friendly interface ensures that companies can navigate their collection strategies more effectively.

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Media

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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

Customer Service / Support

Standard Support
Web-Based Support

Customer Service / Support

Not specified

Training Options

Documentation Hub

Training Options

Not specified

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

Stipulate Technologies Inc.

Date Founded

2026

Company Location

United States

Company Website

stipulatesystems.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

Debt Collection

Not specified

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