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ease
features
design
support

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Description

EncoderPro Spotlight, developed by OptumCoding, is an online medical coding reference tool specifically crafted to assist professionals involved in ambulatory coding, billing, and reimbursement by providing them with timely and precise access to various code sets including CPT, HCPCS Level II, ICD-10-CM/PCS, and ICD-9-CM, as well as relevant regulatory guidance; this software boasts robust search and reference functionalities that integrate numerous procedure, service, supply, and diagnosis codes along with detailed descriptive and cross-coding data, allowing users to swiftly identify the appropriate codes and minimize submission errors. In addition to fundamental code listings, it also offers unique content and tools that enrich users' understanding of compliance issues, addressing topics such as National Correct Coding Initiative (NCCI) edits, Hierarchical Condition Categories (HCCs), and policies regarding coverage determinations, while featuring automated review options for correct unbundling and modifier application, alongside a comprehensive historical content database for adjudication purposes. This makes EncoderPro Spotlight an invaluable resource for coding professionals seeking to enhance their accuracy and efficiency in the complex landscape of medical coding.

Description

Virtual Examiner®, PCG Software’s flagship product, monitors an organization's internal claims process to track provider data for fraudulent or abusive billing patterns and maximizes financial recovery. The Virtual Examiner®, a PCG Software product, allows healthcare organizations to improve their claims adjudication system by allowing for more than 31,000,000 edits per claim. The software monitors an organization's internal claim process to identify and reduce payments for incorrect or erroneous code to save premium dollars. Virtual Examiner®, is more than a claims management solution that focuses on code combinations. It is a cost containment solution that evaluates the claim not only for abusive billing patterns but also identifies those claims that may involve third-party liability/coordination of benefits, case management opportunities, physician billing education and many other cost recovery reports.

API Access

Has API

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

Optum

Country

United States

Website

www.optumcoding.com/online-coding/encoderpro-spotlight/

Vendor Details

Company Name

PCG Software

Founded

1984

Country

United States

Website

pcgsoftware.com/product-offerings/virtual-examiner/

Product Features

Product 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

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