Affiliated Doctors of Orange County Selects PCG Software.Contract will enable the independent practice association to retain premium dollars by using the Virtual Examiner[R] solution MALIBU, Calif. -- PCG PCG phonocardiogram. Software, a leading provider of innovative software solutions designed to increase profitability for healthcare payer and provider organizations, today announced that Affiliated Doctors of Orange County (ADOC ADOC Associazione per la Difesa e l'Orientamento dei Consumatori ADOC Alabama Department of Corrections ADOC Arizona Department of Commerce ADOC Arizona Department of Corrections ADOC Air Defense Operations Center ) will implement the company's Virtual Examiner[R] solution. The new claims auditing system will allow ADOC to monitor its internal claims process and retain premium dollars by identifying unclean claims. "Prior to working with PCG, we had no reliable way of reviewing and adjusting inaccurate claims, and we were concerned that we were losing revenue through overpayment o·ver·pay v. o·ver·paid , o·ver·pay·ing, o·ver·pays v.tr. 1. To pay (a party) too much. 2. To pay an amount in excess of (a sum due). v.intr. To pay too much. ," said John Ernsberger, MD, chief executive officer and chief medical officer of ADOC. "Now with Virtual Examiner, our claims staff can audit claims automatically before the checks are cut and sent out the door. This way, we ensure our payments are right the first time." Virtual Examiner is a cost containment cost containment, n the features of a dental benefits program or of the administration of the program designed to reduce or eliminate certain charges to the plan. solution that allows customers like ADOC to not only reduce payment for improper or erroneous erroneous adj. 1) in error, wrong. 2) not according to established law, particularly in a legal decision or court ruling. coding, but also correct underpayments of claims before payment is made. Virtual Examiner evaluates claims for fraudulent The description of a willful act commenced with the Specific Intent to deceive or cheat, in order to cause some financial detriment to another and to engender personal financial gain. and abusive Tending to deceive; practicing abuse; prone to ill-treat by coarse, insulting words or harmful acts. Using ill treatment; injurious, improper, hurtful, offensive, reproachful. billing practices, and identifies claims that may involve third-party liability/coordination of benefits, case management opportunities, physician billing education and many other cost recovery possibilities. "The Virtual Examiner solution has retained thousands of dollars annually for our clients," said Michael Lubao, chief executive officer of PCG Software. "We are confident that ADOC will experience significant results using this cost containment solution, and look forward to seeing how this success will affect the association's bottom line." An independent practice association, ADOC is a medical group comprised of more than 275 private physicians and 600 specialty physicians with offices throughout the greater Orange County area, including urgent care centers and hospitals. The association is affiliated with most major health plans, including many HMOs. About PCG Software Established in 1984, PCG Software (www.pcgsoftware.com) is a leading provider of innovative software solutions designed to increase profitability for healthcare payer and provider organizations. The company's user-friendly software tools automate cost containment through more accurate and efficient claims adjudication The legal process of resolving a dispute. The formal giving or pronouncing of a judgment or decree in a court proceeding; also the judgment or decision given. The entry of a decree by a court in respect to the parties in a case. for national and regional health insurance plans, independent practice associations, and third party administrators. |
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