Reducing Healthcare Overspending

PCG Software delivers secured quarterly and often bi-weekly coding logic and reimbursement updates directly into client environments through secure SFTP processes. Unlike many traditional vendors that update only a few times per year, PCG continuously maintains its AI-driven knowledge base to reflect evolving CMS, AMA, Medicaid, modifier, diagnosis, and reimbursement requirements.

Static code books and annual releases alone are no longer enough to maintain compliance in modern healthcare reimbursement environments. PCG’s continuously updated AI knowledge base evaluates complex coding relationships, frequency limitations, modifier interactions, and reimbursement logic far beyond what traditional manuals or outdated adjudication systems can support.

Delayed coding updates can lead to claims being processed against outdated reimbursement rules, increasing the risk of overpayments, audit findings, penalties, and operational exposure. PCG Software helps organizations remain aligned with current regulatory requirements while improving payment integrity and reducing compliance-related financial risk.

PCG Software’s technology was built specifically to manage the growing complexity of modern healthcare reimbursement and payment integrity operations. By combining AI-driven claims auditing with one of the industry’s largest proprietary reimbursement knowledge bases, PCG helps payer organizations automate review processes, strengthen coding consistency, and improve long-term financial stability.

Throughout the 1980s and 1990s, Michael helped build operational efficiencies with payer organizations, tested their internal and external network securities, and is a master at Del Phi, Java, and nearly every coding language there is. From software programming, to machine learning to hardward and software requirements, we dare you to find someone with his level of expertise.

When President Clinton adopted the NCCI edits in 1996, Michael was running an MSO and doing claims by hand. He knew that he needed to create a coding directory so that it would enable him and his claims team to quickly identify the proper code, modifier, place of service and remain compliant. Each quarter he would update his directory and this directory became the knoweldgebase that over 170 payer organizations have used to pay claims correctly since then.

With over 50 years in nursing and more than two decades in healthcare administration, Andria Jacobs brings unmatched clinical and operational expertise to PCG Software. She has led hospital and IPA teams nationwide and plays a pivotal role in fraud, waste, and abuse (FWA) training and compliance guidance for our clients—helping every organization strengthen accuracy, accountability, and quality of care.

As PCG’s Chief Operating Officer, Andria oversees daily operations and leads the Las Vegas team, ensuring every client engagement meets the company’s high standards for accuracy, service, and compliance. She plays a key role in client reviews and determinations while also managing employee benefits, pension programs, and internal operations to keep PCG running efficiently and effectively.

Will Schmidt has spent more than 15 years working across healthcare operations, pharmacy, revenue cycle management, staffing, and healthcare technology consulting. He helped build one of the world’s largest pharmacy organizations, including its home infusion and home healthcare divisions, later served as CEO of an international healthcare staffing company, and also led an international medical billing and revenue cycle management organization. Throughout his career, Will has consulted with more than 1,000 healthcare companies ranging from providers and billing organizations to healthcare technology and managed care entities, bringing a strong operational and growth-focused perspective to healthcare strategy and innovation.

Will Schmidt brings a unique combination of healthcare operations, enterprise sales, marketing strategy, and business development experience spanning payer organizations, provider groups, revenue cycle management, healthcare staffing, and healthcare technology. Over the past 15 years, he has helped scale healthcare companies through strategic sales positioning, operational consulting, contract negotiations, branding, digital marketing, and revenue growth initiatives. His background includes structuring enterprise software agreements, PMPM licensing models, reseller and OEM strategies, healthcare compliance positioning, and ROI-driven sales campaigns focused on C-suite healthcare executives. In addition to healthcare SaaS growth strategy, Will has extensive experience in SEO, paid advertising, local search optimization, branding, and conversion-focused marketing systems, allowing him to bridge technical healthcare solutions with modern sales and marketing execution. At PCG Software, he leads strategic growth initiatives, enterprise prospecting, partnership development, proposal strategy, and market positioning efforts focused on payment integrity, fraud, waste and abuse prevention, compliance, and AI-driven healthcare automation.

Steve Pataki, our Sr. Integrations Specialist, is based out of PCG’s headquarters in Las Vegas. He leads our quarterly update process and ensures seamless connectivity across all client environments, keeping systems aligned with the latest coding and reimbursement logic.

Leticia Luna, our Sr. Business Operability Analyst, is based out of PCG’s headquarters in Las Vegas. She works closely with clients to ensure operational workflows align with Virtual Examiner®, helping teams move efficiently from claim review to final determination.

Linda Haas, our Nurse Determination Coder, brings over 40 years of experience across multiple medical specialties. She supports clients by applying clinical expertise to coding determinations, ensuring accuracy, consistency, and defensible claim decisions.

Linda works directly with our client's accounting and finance departments to execute and pay off licensing fees, support fees, and training.