PCG Software Upgrades flagship cost containment software
Virtual Examiner system now nearly 50 percent faster, while
adding new reports, features and enhanced screen layouts
MALIBU, Calif. — May 8, 2007 — PCG Software, a leading provider of innovative software solutions designed to increase profitability for healthcare payer and provider organizations, today announced a major software upgrade of the company’s flagship product, Virtual Examiner. PCG Software's Virtual Examiner enhances claims adjudication systems with more than 31 million edits per claim to protect against fraudulent and abusive billing practices.
Through the enhanced use of in-memory tables and an increase in cache space, the number of claims that a healthcare payer can process using Virtual Examiner has nearly doubled to 233,000 lines per hour, up from 125,000. Also, the cost containment software includes a new charting section, called Graph It!, that will allow users to create line, bar and pie charts to graphically represent their data.
Other significant enhancements include the addition of thousands of edits, new reports, features and screen layouts:
- 2,500 new VE core (non-CCI) edits
- New fraud and abuse report section
- Top 40 unbundling by group and by provider
- Double bills submitted by group
- Churning: Outlier hours/quantities and overrides
- Spiking: Bill submission frequency by group and provider
- Trending: E&M bell curve analysis by group and provider
- Enhanced menu screen with new categories and options
“Our clients process thousands of medical claims per day and must carefully guard against overpayments that cut into patient care treatment dollars," said Michael Lubao, chief executive officer of PCG Software. “Virtual Examiner’s new features include a robust reporting section that assists the payer in investigating possible fraud and abuse situations. It allows healthcare payer organizations to review their providers billing patterns through graphical representations. These graphs will assist them in assessing aberrant billing trends.”
Virtual Examiner helps healthcare organizations identify unclean claims and reduce payment for improper or erroneous coding. It also identifies claims that may lead to cost-recovery, such as third-party liability/coordination of benefits, case management opportunities, and physician billing education. Virtual Examiner has been successfully tested and used on Microsoft’s Vista operating system.
About PCG Software
Established in 1984, PCG Software (www.pcgsoftware.com) is a leading provider of innovative software solutions designed to increase profitability for healthcare payer and provider organizations. The company’s user-friendly software tools automate cost containment through more accurate and efficient claims adjudication for national and regional health insurance plans, independent practice associations and third party administrators.
Press contact information:
Dave Anderson, Dodge Communications, (770) 998-0500 ext. 229
danderson@dodgecommunications.com
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