Case Study: Physicians Integrated Medical Group cuts claims errors and saves costs with PCG Software’s Virtual Examiner

Physicians Integrated Medical Group (PIMG) - Customer Case Study

Physicians Integrated Medical Group (PIMG), an independent practice association serving San Francisco and San Mateo County, was facing rising medical expenses and an overwhelming claims workload as it grew. Its team of seven claims auditors had been reviewing claims manually, but struggled to catch mismatched CPT and ICD-9 codes quickly enough. To improve accuracy and reduce billing costs, PIMG turned to PCG Software and its Virtual Examiner® claims auditing solution.

PCG Software’s Virtual Examiner® automated PIMG’s claims adjudication process by flagging unclean claims as soon as they entered the system and generating remittance reports to explain reductions or denials. The solution helped PIMG identify about 325 to 350 unclean claims each month and delivered immediate savings of $25,000 to $30,000 per month, with a return on investment within three months. It also improved provider education by helping prevent repeated coding errors and better aligning claims with state and federal billing rules.