Case Study: Naperville Health Care Associates achieves 56% savings increase with PCG Software's Virtual Examiner

Naperville Health Care Associates - Customer Case Study

Naperville Health Care Associates, the Physician-Hospital Organization of Edward Hospital in Naperville, Illinois, needed a new claims code auditing system after its existing software vendor was bought and support for the old system was discontinued. With a small staff handling a very large claims workload, NHCA needed a more efficient, paperless way to manage claims review. PCG Software provided the answer with its Virtual Examiner® claims code auditing system.

PCG Software implemented Virtual Examiner® and had it running within a month, using a 12-month sample of prior claims to identify missed savings opportunities. The new system delivered strong measurable results, including a 56 percent increase in claims savings on fee-for-service claims, more than a 500 percent increase in savings on capitated services, and an ROI in just five months. It also improved workflow efficiency and gave NHCA greater capacity for growth without adding staff.