PCG Software Inc.

08/20/2026

🎓 PCG’s new iVECoder® Student & University Program just enrolled its first student.

Less than three weeks after launch, we’re already seeing interest from the next generation of medical coding professionals—and the instructors helping prepare them.

The program was created to give medical coding students access to the same professional coding environment they’ll encounter in healthcare, while helping instructors bring more hands-on instruction in coding, reimbursement, and payment integrity concepts into the classroom.

iVECoder supports research across CPT®, ICD-10-CM, HCPCS Level II, modifiers, CCI relationships, reimbursement methodologies, RVUs, GPCIs, and more.

Students can currently access iVECoder for incredibly reduced rates, while universities and course creators can enjoy discounted enterprise rates.

We’re excited to see our first enrollment—and even more interested to see where this program goes as students begin using iVECoder at the very beginning of their healthcare careers.



Program Details: https://bit.ly/4wF7iLY

08/18/2026

Is your team billing CPT® 96372 correctly?

Injection administration may seem straightforward, but documentation errors, modifier misuse, medical necessity issues, and incorrect code selection can all contribute to denials, delayed reimbursement, or audit findings.

We've published a comprehensive guide covering:

• When CPT 96372 should be reported
• Documentation requirements
• Common billing mistakes
• Medicare and commercial payer considerations
• Modifier guidance
• Payment integrity risks
• Coding compliance best practices

Whether you're a provider, biller, coder, auditor, or payment integrity professional, this resource is designed to help improve coding accuracy and reduce reimbursement risk.

Read the full guide:
https://bit.ly/4697Izi

08/12/2026

Billing Guide for Psych Diagnostic Evaluation
CPT 90791
Definitions, Usage Scenarios, do's and don'ts, financials, and more.
Providers - stop getting denials
Payers - teach your providers
https://bit.ly/45o7eFm

08/10/2026

We're honored to share that PCG Software has been recognized as one of the Top 10 AI-Powered Healthcare Companies of 2026 by MedHealth Review.

For more than three decades, our mission has remained the same:

Help healthcare organizations reduce unnecessary costs, strengthen compliance, improve payment integrity, and make better decisions through intelligent automation.

Long before AI became today's headline, our team was applying millions of coding edits, reimbursement rules, and payment integrity logic to help health plans, TPAs, MSOs, IPAs, PACE organizations, and provider groups identify billing errors, reduce improper payments, and streamline claims operations.

Today, that mission continues to evolve through AI-assisted claims auditing, fraud, waste, and abuse analytics, real-time authorization intelligence, and workflow automation.

This recognition belongs to our employees, clients, partners, and everyone who has trusted PCG Software over the years. Your feedback and collaboration have helped shape every product we build.

As healthcare continues to embrace AI, we remain committed to delivering solutions that are practical, transparent, compliant, and focused on measurable outcomes—not hype.

Thank you to MedHealth Review for this recognition, and thank you to our clients for allowing us to be part of your journey.

Read the article here:
https://bit.ly/4z9OiHY

08/06/2026

Almost every day, PCG gets asked at least 3 of these 10 questions about AI and automation.
So we made a short, simple Q&A guide.
Give it a read!

https://bit.ly/4hchvvj

07/06/2026

Greetings all,
We'd like to ask for help, just 10 seconds of your time.
1) Click our profile
2) Click the reviews
3) Leave 5-stars and a short message.

It would really help our page and updates reach amazing people and companies just like yours, and help them understand there is an independently owned and operated company trying to reduce the cost of healthcare instead and battle fraud, waste, and abuse.

Thanks!
Will and the team at PCG!

Send a message to learn more

07/04/2026

06/29/2026

NEWLY PUBLISHED: Payer SIU Guide

• FWA investigation workflows
• SIU staffing structure
• Fraud analyst, investigator, and supervisor roles
• Claims analytics and provider profiling
• Compliance, referral, and recovery considerations

Read the full guide on our website at:
https://bit.ly/4oTN3rz

06/23/2026

FWA IN THE HEARTLANDS

State: North Dakota
Specialty: Home & Community-Based Services (HCBS)
Amount: Not Disclosed
Category: Documentation & Compliance Failures
Date: June 18, 2026
Organization: North Dakota Medicaid Waiver Program
Source: HHS-OIG https://bit.ly/4vpNhsP

DESCRIPTION:
Oversight reviews identified provider noncompliance involving records management, health and safety requirements, and documentation standards within Medicaid HCBS residential programs.

CODING & BILLING ISSUES:
• Documentation deficiencies
• Provider compliance failures
• Service verification concerns
• Recordkeeping weaknesses

PAYMENT INTEGRITY TAKEAWAY:
As Medicaid HCBS programs continue expanding nationwide, plans and state agencies face increasing pressure to validate services, monitor providers, and ensure regulatory compliance.

HOW VE COULD HAVE PREVENTED THIS:
• HCBS service-pattern analytics
• Provider risk scoring
• Documentation compliance dashboards
• Service verification reporting
• Provider monitoring and trend analysis

06/23/2026

FWA UPDATES: MEDICARE OVERPAYMENT AUDIT
State: Arkansas
Specialty: Hospital Services
Amount: $4.7 Million
Category: Medicare Overpayments
Date: June 17, 2026
Organization: Jefferson Regional Medical Center
Source: HHS-OIG https://bit.ly/4vpNhsP

DESCRIPTION:
An OIG audit found that Jefferson Regional failed to meet Medicare billing requirements on 33 of 100 sampled claims, resulting in at least $4.7 million in estimated overpayments.

CODING & BILLING ISSUES:
• Inpatient billing errors
• Outpatient billing errors
• Documentation deficiencies
• Medicare reimbursement compliance failures

PAYMENT INTEGRITY TAKEAWAY:
Hospital claims continue to represent one of the largest recovery opportunities for payers due to billing complexity, regulatory changes, and documentation requirements.

HOW VIRTUAL EXAMINER COULD HAVE PREVENTED THIS:
• Facility billing edits
• Medicare compliance validation
• High-risk claim identification
• Documentation sufficiency review
• Hospital audit targeting analytics