Today’s managed care industry is witnessing a business climate in which billions of premium dollars spent on healthcare are lost to fraudulent and abusive billing practices each year. Of the $3 trillion spent on healthcare annually, the National Health Care Anti-Fraud Association (NHCAA) estimates that healthcare organizations lose at least 3% or $60 billion a year to fraud and abuse. Other estimates by government and law enforcement agencies approximate the loss to be as high as 10% or $300 billion of the nation’s expenditure. Left unchecked, the resulting increases in healthcare costs can lead to benefit cutbacks, increased premiums, and higher out-of-pocket medical costs.
For more than thirty years, PCG Software’s mission has been to help its healthcare payer clients reduce the cost of healthcare by providing software solutions that address these challenges.
CLICK HERE to download a PDF of the PCG Software Payer brochure.
Protect healthcare dollars from fraudulent and abusive billings
Assure proper diagnosis and procedure coding for interactive authorization and claims
Manage and trend physician credentials, and track documents, office demographics and assessments
Efficiently detect fraud and abuse using our workflow management application
Speed the healthcare claims review process