AI Medical Coding Software Solutions

Bridging Minds with AI

Reducing Healthcare Costs and Targeting FWA

If you pay out claims without Virtual Examiner®, you are losing money and risking CMS audits and possible de-delegation. For over 30 years, we've helped 170+ payer organizations, ranging from those with 1 to 200 lines of business and 10,000 to over 5 million lives, manage the numerous new and existing requirements imposed by CMS, AMA, and Medicaid, with partial to full risk. It's too much for one person to know, so we created the world's #1 AI medical coding and compliance database with all the answers and suggested edits you need. Never pay out an incorrect claim again and improve your encounter data.

Our Story & Leaders

Rules and Edits

30 years of quarterly coding and rule updates across CMS, AMA, and Medi-Cal allow us to share the world's largest coding database.

AI ROI

99% of our clients have seen an ROI from VE within 90 days or less by applying only 75% of VE-suggested denials.

Free Audits & Trials

Claim your free payer audit to find out VE's true ROI and impact in 30 days or less.

Claim FREE Audit

Payer Claims Auditing Solutions

Payers, MSOs, PACE, and TPAs

Virtual Examiner (VE)

The world's only full episode of care claims auditing solution for payer organizations. Enable your team to walk into work with an existing workflow for problematic claims, what's wrong with them, and suggestions on how to deny, reduce, or pend them for contractual review.

Payer Cost & FWA

claims automation,real-time claims auditing

Payer Automations & Integrations

VE + VA Live

Exclusive for VE Clients only: Once you're live with VE, adding VA Live can help you automate authorization denials based on CCI or your own custom edits. Following VA Live, you can consider claims automated denials through our automation partners.

Payer Automation

High Desert Medical

Virtual Examiner and Virtual AuthTech have been game changers, enabling us to save taxpayer dollars while remaining compliant with an ever-changing payer requirements landscape. Highly recommend!

Medpoint Management

The integration of Virtual Examiner, Virtual AuthTech, and real-time claims auditing within VEWS has empowered us to customize our business lines, auditing processes, and compliance measures in ways we once only imagined.

InnovAge

As a PACE program, cost containment and compliance is so important. Every dollar paid is a taxpayer dollar. We take every claim seriously, but VE and VA allow us to ensure that our providers are paid every cent as well.

Code Scrubbing Integrations

Decrease denials and increase compliance with our AI medical coding scrubber

Clinics, Provider, and RCM

iVECoder

If your medical group or clinic is frequently facing denials, our team is here to assist you in leveraging iVECoder to identify the underlying reasons, rectify any billing inaccuracies with our software, and guide you on how to use iVECoder to negotiate improved reimbursement rates for your most commonly billed codes. What are you waiting for?

for Providers

for RCM Companies

code scrubber for medical billing companies

Billing Software Integrations

VEWS

Billing software providers and clearinghouses seeking a code scrubber prior to submitting payer claims need look no further. VEWS boasts over 72 million edits, and when integrated effectively, it can minimize denials while enhancing billing staff's understanding through payer-level insights. It’s the complete coding solution in one!

for Billing Software

Pinnacle Brokers

I've partnered with PCG for over 12 years, and they've saved my payer clients millions in claims auditing and countless taxpayer dollars with their FWA strategies.

QuickCap

Virtual Examiner has helped our MSOs and PACE programs seamlessly take control of their compliance in remarkable parallel to our software systems.

Key Software

PCG's AI claims auditing system has enabled our prospective clients to save millions, thus allocating additional funding for our AI agents and solutions. Great partnership!