Medicare Pricing and Contract Management Solutions Made Easy

Most Accurate, Highly Secure and Lowest Cost Solutions on the Market

Why use CMSPricer to re-price and edit your Medicare claims?

No Set Up

Web-based with results returned in seconds priced at 100% of Medicare rates. Hand Key Entry or Auto Batch/EDI Uploads, Easy imports/exports. 

No Hassle

No contracts, No sales people…..pre-pay purchase with volume discounting and easy online payment processing.

Accurate

Frequent engine updates with latest CMS policies and rates to ensure accurate claims pricing. The CMS.Gov typically has a 3 month lag time and incomplete pricing results. We price all PPS types of Institutional and Professional claims including claim editing for Referenced Based pricing.

Security

No PHI or claims data stored. Utilizes contemporary cloud-based security, including EV SSL Certificate, 5HA2, and 2048 bit encryption (strongest on the market). Fully HIPAA and ANSI 837 version 5010 compliant. Every user has their secure login and account. 

Availability

As long as you have access to the Internet, you can run 24/7/365 securely *excluding short windows for system maintenance.

Our Clients

We serve Payers, PPOs, TPA’s, BPO’s, Self-Funded Employers and Auditing Firms.

New Users 5 Claims FREE no commitments

NO SOFTWARE TO INSTALL

NO COMPLEX CONTRACT TO SIGN

USA OWNED AND OPERATED

100% ON-SHORE RESOURCES

ACCURATE SaaS CLAIMS PROCESSING

EASY MANUAL, BATCH OR API Claims Integration Claims ENTRY

Why our clients value us:

Our latest blog update

Hassle-Free Medicare Pricing & Contract Management

What Makes CMSPricer the Go-To Solution for Hassle-Free Medicare Pricing and Contract Management?

By pwsadmin | March 20, 2025

Managing Medicare pricing and contracts can be challenging for payers, TPAs, and self-funded employers. CMSPricer, a leading SaaS platform, offers a streamlined, secure, and cost-effective solution for Medicare claims processing.Here’s why CMSPricer stands out for healthcare cost management:1. Quick and Easy Access with Zero SetupCMSPricer offers a web-based architecture that eliminates the need for setup…

Navigate Medicare Pricing Contracts Easily with CMSPricer

Does Medicare Pricing Contract Claims Feel Like a Maze? Navigate It with CMSPricer!

By pwsadmin | March 5, 2025

For contract managers, third-party administrators (TPAs), preferred provider organizations (PPOs), and self-funded employers, pricing claims at specific rates can seem like piecing together a complex puzzle. Balancing various fee schedules, monitoring provider networks, and ensuring precise CMS pricing requires constant attention. The task of manual repricing is not only tedious but also increases the chances…

Simplify Medicare Repricing for CMSPricer’s API & Batch Processing

How Can CMSPricer’s API and Batch Processing Simplify Medicare Repricing for Seamless CMS Compliance?

By pwsadmin | February 18, 2025

Managing Medicare claims processing can be overwhelming, particularly when navigating CMS compliance rules, pricing edits, and batch processing. Whether you are a TPA, PPO, BPO, or a self-funded employer, ensuring accurate claims pricing is crucial for both compliance and cost savings. So, how can you streamline this process effectively? The key is CMSPricer’s Medicare repricing…