AI Medical Coding Software
Healthcare Coding Software Solutions
Helping Payers audit claims pre-payment to ensure maximum cost containment, compliance, and workflow efficiency for 30 years.
The #1 AI Medical Coding and Claims Software
AI Automation for Healthcare
If you pay out claims and don't have Virtual Examiner®, you are losing money and time, period. For over 30 years, we've helped 164 payers, ranging from 1-200 lines of business, 15,000 to over 5 million lives per client, with partial to full risk, manage the endless new and current requirements that CMS, AMA, and Medicaid place on you. It's too much for one person to know, so we created the world's #1 AI medical coding and compliance database with all of the answers and suggested edits you need never pay out a incorrect claim again and improve your encounter data.
Which AI Solution Do You Need?
Virtual Examiner® Suite
VE® is the world's #1 claims auditing, compliance, and cost containment software suite that over 164 payers use every day.
Virtual Reporter®
Powered by VE, Virtual Reporter is nightly audit of all the day's claims that require your attention. Learn more about VR now.
Partial Client List
Built on AI and 30 Years of Success
Naperville Healthcare Associates
Initial 56% percent savings on fee-for-service...
Physicians Integrated Medical Group
Immediate $30,000 check-run claims reduction...
Tuality Health Alliance
10% overpaid claims reduction in first month...
The PCG Healthcare Blog
How to gain more providers, more members, and increase retention, all through this free payer marketing strategy guide.
Real-time article chronically DOGE's auditing of CMS and US Healthcare costs to help reduce the cost of healthcare and save taxpayer spending.
How to navigate the healthcare merger and acquisition market in 2025. Strategies, tips, real-life scenarios, and guidance from PCG's CSO who's been through them, on both sides of the table, and lived to tell about it.
Free guide for health plans, MSOs, and IPAs to prep for the incoming OIG audit.
Learn about CPT code 69210: removal of impacted earwax using specialized tools. Discover key details, documentation tips, common modifiers, and approved settings for accurate billing and reimbursement.
Discover why traditional CPT code books are outdated and costly compared to iVECoder's real-time, automated medical coding solution. Learn how weekly updates, affordable pricing, and workflow efficiency can revolutionize claims processing for health plans and billing professionals. Read now!
Health Plan strategies for natural disasters in terms of continuity of care, claims and authorization, and more. We hope these ideas and strategies help your organizaiton.
CPT Code 20610 descriptions, usages, modifiers, places of service, and examples with pictures and content. Learn about this aspiration and/or or injection of fluid from major joints today.
New HIPAA and PHI regulations in 2025 to help safeguard against Cyber Attacks. Who will pay the bill for these initiatives, and how or will this actually help?
Learn how California health plans now have to pay claims out in 30 calendar days instead of 30 business days, and the impacts they will experience and solutions they should consider.
CPT Code 90837 description, examples, modifiers, places of services, and helpful tips for cleaner claims for both payers and providers.
Quick and easy to read guide on how to hire, fire, and retain your health plan employees.
We review the 2024 CAHP Conference, what it is, how it went, and if it's right for your plan to attend the next year.
CPT code 82310 description, modifiers, case uses, bundled codes, and images illustrating everything you need to know to process claims or submit claims within compliance.
CPT Code 88365 descriptions, usages, modifiers, places of service, bundled codes and tips on how to adjudicate or submit cleaner claims. Backed by AMA licensing info.
CPT code 88323 descriptions, case usages, financials, bundled codes, CCI edit considerations, and more. Learn about the code as well as how AI coding scrubbers can help with efficiency, accuracy, and compliance.
Guidance on the usage of AI for healthcare prior authorizations for payers and providers in 2024-2025 and beyond. We will continually update and improve this blog as new developments occur.
CPT Code 51703 definition, usage, modifiers, financial details, and more. Click to learn about the complicated insertion of bladder tube.
01996 cpt code is Daily hospital management of continuous spinal drug administration. Learn about it's history, definitions, cms statuses and more.
Latest medicla coding changes, latest medical coding claims information, a look at our quarterly newsletter to our clients, all information obtained from; CMS, AMA, and the WHO.
CPT code 99214 defined, explained per CMS and AMA guidelines, with pictures and helpful tips on how to avoid denials.
The history and latest updates on the cyber attack of ChangeHealthcare owned by United Healthcare Group.
Explore how AI can help your health plan reduce costs and increase compliance with AI claims auditing.
Cano Health files for bankruptcy. Who are they? Why did it happen? What's the fallout?
AI and EI discussion. Can it happen? Yes, find out how. Should it happen? Here what we, an AI company, say about it.
CPT 20220 definitions, case uses, bundles, financials, and how to get clean claims through the use of AI.
Violation tracker of UnitedHealth Group's continued fraudulent activities and fines.
Explore how a 2014 article on mental health fraud still has the same issues in today's healthcare. Read it and be amazed that 9 years later the same problems exist. Examine history or you're doomed to repeat it.
AI has been in healthcare since 1995. Learn how it has grown and how PCG software's predictions were spot on. Also includes statistics on denials, fraud, and compliance.
Summary of Biden's new AI Executive Order for healthcare and how it will impact your plan.