EncoderPro.com
EncoderPro Spotlight by OptumCoding is a web-based medical coding reference application designed to help ambulatory coding, billing, and reimbursement professionals manage critical coding tasks with accurate, real-time access to CPT, HCPCS Level II, ICD-10-CM/PCS, and ICD-9-CM code sets and associated regulatory guidance; the software includes powerful search and reference capabilities that combine thousands of procedure, service, supply, and diagnosis codes with descriptive and cross-coding information so users can find the right codes quickly and reduce errors in claim submission. It provides proprietary content and tools that go beyond basic code lists to include deeper insights into regulatory compliance topics such as National Correct Coding Initiative (NCCI) edits, Hierarchical Condition Categories (HCCs), and coverage determination policies, automated edit review options for proper unbundling and modifier use, and a historical content database for adjudication reference.
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Easy Coder
Easy Coder includes efficient procedure and diagnosis code search, encounter editing, and compliance tools all in one easy-to-use program. The solution leverages its web-based platform to provide real-time updates to content, rule changes, and policies, with no need to install the software. Verifies medical necessity. Saves coding time. Combines all aspects of coding. Allows for corrections early in the revenue cycle workflow. For almost 15 years, our medical billing service has been a daily user of Alpha II’s EasyCoder. It has proved to be an invaluable tool, providing my staff with quick access to current, comprehensive, and reliable coding resources. The E&M Generate, the policy reviewer, supporting diagnoses lists, and access to the Medicare fee schedules by locality have developed our staff’s knowledge and confidence as we strive to serve our clients as a trusted resource.
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Virtual Examiner
Virtual Examiner®, PCG Software’s flagship product, monitors the internal claims process of an organization to trend provider data for fraudulent and abusive billing patterns, and maximizes financial recoveries. PCG Software’s Virtual Examiner® allows healthcare organizations to enhance their current claims adjudication system with more than 31 million edits per claim. The software solution monitors an organization’s internal claims process to identify unclean claims and reduce payment for improper or erroneous coding to conserve premium dollars. Virtual Examiner® is more than a claims review solution with a focus on code combinations. It is a cost containment solution that evaluates the claim not only for abusive billing patterns but also identifies those claims that may involve third-party liability/coordination of benefits, case management opportunities, physician billing education and many other cost recovery reports.
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Amy by CombineHealth
Amy by CombineHealth is an AI medical coding automation solution that helps mid-sized hospitals and multi-specialty physician groups automate complex coding workflows with confidence. Amy supports CPT, ICD-10, HCPCS, E/M, modifiers, and specialty-specific coding requirements.
Amy analyzes clinical documentation, coding guidelines, payer logic, and specialty-specific rules to generate accurate, explainable coding recommendations. It helps identify missed services, documentation gaps, undercoding opportunities, and coding exceptions, with evidence for each suggested code.
A key differentiator is Amy’s feedback loop: for every chart it codes, downstream claim outcomes such as denials, payer responses, and reimbursement results are used to improve future coding performance and reduce repeat errors. In production, Amy has delivered 98%+ coding accuracy, up to 85% coding automation, and a 75% reduction in coding-related denials.
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