DataWing Software® offers expert healthcare data solutions for eligibility, capitation reconciliation,
and information management.
In an industry where flexibility is essential, EZ-CAP® offers proven and reliable technology to help automate and manage increasingly complex health insurance benefits. The competitively priced EZ-CAP is easy-to-use and easy-to-adapt and configure, while a growing roster of partners enables users to broaden their service offerings.
With EZ-CAP, health plans, independent practice associations, management services organizations and physician-hospital organizations can stay in control of their data and on top of an ever-changing healthcare environment, while efficiently and cost effectively automating their healthcare administration. As their specific needs change, users can simply adapt the EZ-CAP software to suit their evolving requirements.
PLEXIS empowers diverse health plans, including medical, vision, and dental plans, enabling payers to grow and innovate across multiple business lines while maintaining a centralized platform. As new regulatory and technological drivers emerge for accountable care, adjudication modernization, and data aggregation, health plans are improving business efficiencies and member services by leveraging PLEXIS’ proven core administration and claims management platform.
Claim Adjudication Software Tailored for Health Plans, TPA, PPOs, Medicaid, State and Federal Employee Plans and other Commercial and Government Healthcare Payer Organizations.
HealthCare Information Management, Inc. (HCIM) delivers technology solutions and consulting to the managed care payer industry. HCIM’s Software Solutions seamlessly integrate with the industry’s leading core claims transaction systems to increase auto-adjudication, speed turnaround times, and minimize errors:
- SymKey® - process claims 6-8x faster using artificial intelligence to automate workflow decisions
- Virtual Auto-Post™ - auto-post Virtual Examiner®/Reporter™ claim edits
- Virtual Examiner®/Virtual Reporter® - contain costs, detect fraudulent and abusive billing patterns and recover premium dollars
- Claims Audit Tool™ - streamline and automate pre and post payment audit workflow and reporting
HCIM’s Professional Consulting Services include system implementation and configuration, historical data conversions, operational assessments, business process reengineering/analysis, staff augmentation, training, project management, benefit plan administration, and regulatory compliance. HCIM’s Strategic Consulting Practice is designed to help payers navigate the complexities of today’s healthcare marketplace and strategically forge a path to sustained growth through creatively applied technology, process improvement, and innovative problem solving.
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. For more than twenty years, PCG Software's mission has been to help its clients
reduce the cost of healthcare by providing innovative software solutions that address
We recognize that competing in today's healthcare marketplace is more challenging than ever, and that organizations need their software solutions to provide limitless administrative flexibility and functionality.
Our comprehensive suite of software solutions:
- Improves operational efficiency and profitability
- Reduces the amount of internal resources dedicated to administrative functions and manual claims review
- Adheres to complex and ever-changing clinical guidelines
- Can be easily implemented without staff interruption
- Saves employees from having to learn complex and cumbersome software systems