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Medicare and Editing 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 COMPLICATED CONTRACT TO SIGN

ACCURATE SaaS CLAIMS PROCESSING

EASY MANUAL, BATCH OR API Claims Integration Claims ENTRY

Why our clients value us:

“CMSPricer meets our stringent CMS Medicare claims accuracy requirements for auditing claims from over 50 Medicare Advantage plans. Using the CMSPricer SaaS based tool and interface allows us to effectively batch process with ease and precision. Great partner!”  

Davis-Farr

Our latest blog update

CMSPricer Solution Can Reduce Claims Overpayment

By pwsadmin | July 22, 2021

he CMS PC Pricer tool used to estimate Medicare PPS payments. By using the PPS framework implemented into Medicare repricing systems, the TPAs, employers, or audit firms can manage the most complex Medicare repricing solutions.   Medicare repricing systems can automate the process of accurate editing, grouping, and pricing across multiple care settings. It enhances Medicare…

Medicare Claims Automation at Scale: Top 4 Benefits for Payers

By pwsadmin | June 24, 2021

Behind-the-scene machinations of Medicare claims procedures are now much more complex than those days when Medicare claims automation tools came on board. Today’s procedures are often so complicated that they tend to take a couple of weeks or even more due to the streamlining and standardization of critical processes such as claims repricing.  Thanks to…

Empower Your Medicare Advantage Claims Repricing Business with CMSPricer

By pwsadmin | June 18, 2021

In order to sail your Medicare Advantage claims repricing processes through this current Medicare environment, you need a reliable system that can empower you with the right solutions to carry out the tasks efficiently. And for Medicare claims repricing, in particular, you need a customizable platform that allows automation processes and guarantees regulatory compliance through…