HCIM and PCG Software Announce Partnership to Reduce the Cost of Healthcare for Payers and Other Managed Care Organizations

HCIM to Serve as the Exclusive Value-Added Reseller for PCG Software’s Virtual Examiner® and Virtual Reporter®

HCIM and PCG Software, Inc. (PCG) today announced an exclusive value-added reseller (VAR) agreement to resell PCG’s Virtual Examiner® and Virtual Reporter® (VE/VR) claims recommendation software to the healthcare payer/managed care industry. With the use of more than 30 million claim edits, VE/VR compares claims against a strict set of industry rules and locates claims with flawed procedure codes and billing mistakes, allowing healthcare organizations to remedy overpayments and recover large sums of money, all while adhering to industry standards.

HCIM and PCG Software have been close business partners since 2007 when they co-developed SymKey® Virtual Auto-Post (VAP) that seamlessly integrates with VE/VR to automatically apply identified claim edits and recommendations back into the client’s core claims transaction system.

“I’m excited to take HCIM and PCG Software’s longstanding business relationship to the next level with this reseller agreement. We have many joint clients across several claims platforms that currently enjoy the use of VE/VR combined with the automation power of VAP, which allows them to detect and remedy fraud, abuse and overpayments without the need to hire and train additional staff to post the claim edits. This will expand HCIM’s rapidly growing product offerings by selling, implementing and supporting VE/VR alongside our own VAP product,” said Michael Wilson, President and CEO of HCIM.

HCIM made the official announcement about its new VAR agreement with PCG Software at the September EZ-CAP® UCON and Plexis user conferences. HCIM and PCG Software exhibited their products and services together to inaugurate the new partnership.

“Each year, the healthcare industry experiences the loss of billions of premium dollars to fraudulent, abusive and wasteful billing practices. PCG’s software solutions combat this loss by targeting providers who exhibit improper or erroneous coding patterns to contain, recover and conserve premium dollars,” said Michael Lubao, CEO of PCG Software. “By implementing, integrating and automating these cost containment solutions, PCG and HCIM are able to work together to streamline the claims process for our customers. HCIM brings a strong customer base and keen insight into what this market needs in terms of technology and services, and we are confident that they are the perfect partner for us.”

About HCIM

Since 2000, HealthCare Information Management, Inc. (HCIM) has delivered technology solutions and consulting services to health care payers and managed care organizations. HCIM’s innovative products augment your existing core claims transaction system and streamline your claims and authorizations operations through business process automation. Our SymKey®, Virtual Auto-Post, and Claims Audit Post software greatly improve turnaround times, reduce inventories, and optimize accuracy, which results in a rapid return on investment and significant time and cost savings. With an array of developmental, operational, implementation/configuration, and regulatory consulting services, HCIM’s staff of professionals can provide the support and knowledge you need to enhance your business operations — positioning you for success in an ever-evolving healthcare marketplace.

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 payer 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, 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. 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. For more information, visit www.pcgsoftware.com, or follow us on Twitter.

About HCIM

Since 2000, HealthCare Information Management, Inc. (HCIM) has delivered expert consulting services and robotic automation tools for small to mid-sized healthcare payer and managed care organizations. Our concierge consulting services include everything from core claims system procurement to go live, including configuration, migration, upgrades, reporting, benefits and fee schedules, user training, and project resourcing. We also offer strategic consulting in the areas of value based payments, population health, medical management, medical loss analysis and recovery, care management, provider contract modeling, data analytics, and business process reengineering/analysis.