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iVECoder by PCG Software

Know What the Payers Know.

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Overview

iVECoder is an AI-powered medical coding software that leverages over 30 years of payer knowledge. It provides a mock adjudication of claims, showing how a payer would process it, including CCI edits and over 450 reason codes. It is updated quarterly with the latest CMS, AMA, and Medicaid rules.

✨ Key Features

  • Mock claim adjudication
  • Payer-based CCI edits and reason codes
  • Quarterly updates of CMS, AMA, and Medicaid rules
  • Layperson descriptions of codes
  • Contract negotiation tool

🎯 Key Differentiators

  • Built from a payer's perspective
  • Mock adjudication feature
  • Focus on 'leveling the playing field' between providers and payers

Unique Value: Empowers providers with the same knowledge and logic that payers use to adjudicate claims, enabling them to fix errors before submission and reduce denials.

🎯 Use Cases (4)

Pre-submission claim review Denial prevention Medical coder training Negotiating payer contracts

✅ Best For

  • Identifying potential claim denials before submission by using payer-side logic.

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • Organizations needing a full practice management or EHR suite.

🏆 Alternatives

AAPC Coder Waystar Optum

Unlike standard claim scrubbers that check for basic errors, iVECoder simulates the entire payer adjudication process for a deeper level of review.

💻 Platforms

Web

🛟 Support Options

  • ✓ Email Support
  • ✓ Phone Support

🔒 Compliance & Security

✓ HIPAA

💰 Pricing

$99.00/mo

✓ 14-day free trial

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