New Auto-Adjudication System Integrates with Virtual Examiner®
Malibu, Calif. — July 03, 2007 — PCG Software, a leading provider of innovative software solutions designed to increase profitability for healthcare payer and provider organizations, and HealthCare Information Management, Inc. (HCIM) a leading technology solutions and consulting services provider, today announced SymKey® Virtual Auto-Post™, a jointly developed solution for healthcare payor organizations. The auto-adjudication system integrates with PCG Software’s flagship solution, Virtual Examiner®, to speed the healthcare claims review process.
The addition of SymKey Virtual Auto-Post to Virtual Examiner will further automate the claims process by automatically posting claim results to the system. This ensures that no one in the billing department needs to manually touch the claim, slowing down the process. In addition, administrators no longer need to physically track or manage items such as retro-rate reconciliation, multi-level fee schedules, eligibility review, and co-pay/co-insurance correction.
“We have blended the expertise of both of our companies to develop a new product that will truly help to streamline the process of medical claims and help end abusive billing practices for healthcare organizations,” said Michael Lubao, chief executive officer of PCG Software. “PCG Software is very excited to be able to demonstrate such a unique solution so early into our relationship with HCIM.”
SymKey Virtual Auto-Post is the result of PCG Software and HCIM’s affiliate vendor relationship which was announced earlier this year. The new product was unveiled by Lubao and Michael Wilson, chief executive officer of HCIM at the EZ-CAP Western Regional User Group Meeting in June.
“Maximizing premium dollars and aiding our clients as they process claims is extremely important to us,” said Wilson. “This new product is the result of the strong working relationship we have with PCG Software. Together, we have been able to develop the first in a series of products that will continue to enhance the
claims process for healthcare organizations.”
PCG Software’s cost containment solutions allow healthcare organizations to monitor their internal claims process to identify unclean claims and reduce payment for improper or erroneous coding to conserve premium dollars.
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 works with healthcare payor organizations to increase profitability and maximize financial recoveries, while assisting their provider partners to improve the accuracy of billing processes. The company’s flagship software solution 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.
Through more accurate and efficient claims adjudication, this fraud and abuse prevention software acts as an automated cost containment system for national and regional health insurance plans, independent practice associations and third party administrators. More information about PCG Software can be found at www.pcgsoftware.com.
About HealthCare Information Management (HCIM)
HealthCare Information Management, Inc. delivers technology solutions and consulting services to the managed care/payor industry. HCIM’s products include: SymKey®, an advanced auto-adjudication claims system; SymKey® Kwik Actions™ – Special Ability Work Navigation tool; ScanClaims™, a complete work-flow and inventory management solution for document scanning, imaging and OCR; Appeals Manager™, an automated solution to handle appeals, grievances and resolutions and P4P – Data Management Solution, a robust pay-for-performance solution.
HCIM consultants are trained and certified in successfully implementing the latest technologies and versions of the industry’s leading payer software applications. Our services include payor application software implementation services such as project planning, business rules configuration, interface/integration of third party applications, conversions, custom software development, report development, testing, and technology/business assessments.
HCIM has accumulated over 150 years of expertise in managed care, healthcare, information technology and business management. For more information about HCIM’s products and services visit the HCIM web site at www.hcim.com.