Coding and billing platform leverages payor intelligence to improve accuracy of medical claims and speed reimbursement while reducing provider risk
LAS VEGAS – April 02, 2019 – PCG Software (PCG), a leading provider of software solutions designed to slow the escalating costs of healthcare, today announced the launch of iVECoder™, a coding and billing intelligence platform for medical practices of all sizes and specialties. Through the cloud-based software subscription, providers can now ensure even the most complex claims are clean and accurate before they are sent to the payor – using the same Virtual Examiner® intelligence claims review engine that healthcare payors worldwide have been using for more than 25 years to determine which provider claims to approve or deny.
“The claims process can take a toll on a healthcare facility. Even with the existing advances in claims technology to make things easier on billers, stringent claims adjudication, payor denials, and the requirement of constant resubmissions can significantly degrade a practice’s ability to remain financially competitive,” said Michael Lubao, CEO of PCG Software. “The iVECoder™ platform empowers medical practices with the same claims intelligence, tools and rules engine that the payors use. By reporting claims accurately from the start, healthcare providers are better equipped to reduce the incidence of claims denials so they can get paid faster.”
The iVECoder™ platform uses embedded billing and coding intelligence to analyze claims submissions in real time and provides users with the crucial appeals support needed for any incoming claims denials from past submissions. Using the same intelligence engine insurance companies use in their auditing process, iVECoder™ helps providers resolve complex coding challenges and maximize reimbursement through a comprehensive code database with filterable lookups including CPT, HCPC, ICD-10 & ICD 9, APC, GPCI Years, Modifiers, Places of Service (POS), Drug-CPT Crosswalks, HIPPS and more. iVECoder™ is also able to easily and accurately calculate pricing in preparation for contract negotiations and auditing the accuracy of payor reimbursement.
iVECoder™ and its internal algorithms were developed using guidelines from the American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS), along with specific state Medicaid or California Medi-Cal coding rules as appropriate. The coding knowledgebase is updated on a daily basis to assure compliance with the frequent business and legislative changes.
For more information on ways in which PCG Software’s iVECoder™ is helping providers combat denials and maximize reimbursement while reducing risk, visit www.iVECoder.com.
About PCG Software
Established in 1984, PCG Software is a leading provider of innovative software solutions designed to slow the escalating costs of healthcare. The company partners with the full spectrum of healthcare stakeholders – from helping healthcare payor organizations to increase profitability and maximize financial recoveries, to assisting provider organizations improve the accuracy of billing processes.
The company’s flagship software solution, Virtual Examiner®, enhances claims adjudication systems with more than 30 million edits per claim and uses investigative profiling reports to graphically indicate patterns of fraud and abuse. The iVECoder™ platform empowers medical practices with the same billing and coding intelligence, tools and rules engine that the payors use to analyze claims submissions in real time.