Case Study: WINhealth Partners saves thousands with PCG Software’s Virtual Examiner

WINhealth Partners - Customer Case Study

WINhealth Partners, the largest HMO in Wyoming, needed to modernize its claims auditing process and make it easier for staff to use. The organization wanted a user-friendly solution that would catch errors and prevent overpayments without requiring extensive training or disrupting existing claims processing. Vendor PCG Software was selected to help address this need.

PCG Software implemented its Virtual Examiner financial recovery and claims adjudication system as an add-on to WINhealth’s existing EZ-CAP platform. The solution identified erroneous and fraudulent claims while remaining largely invisible to claims processors, helping preserve existing workflows. WINhealth reported saving thousands of dollars and recouping the software cost within the first few months of running weekly checks.

WINhealth Partners

Beth Wasson

CEO