Why use CMSPricer to re-price and edit your Medicare claims?
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 contracts, No sales people…..pre-pay purchase with volume discounting and easy online payment processing.
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.
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.
As long as you have access to the Internet, you can run 24/7/365 securely *excluding short windows for system maintenance.
We serve Payers, PPOs, TPA’s, BPO’s, Self-Funded Employers and Auditing Firms.
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!”
Our latest blog update
Employers can anticipate healthcare expenses once they adopt the reference-based pricing (RBP) model. With its implementation, they can determine reimbursements ahead of time, select the prices they are willing to pay for a healthcare service. RBP model saves employers from surprise healthcare expenses for their employees within their company. RBP can result in up to…
Preferred Provider Organization (PPO) & Facilities Now Can Price Any Claim at Any Specific Rate Automatically!
Healthcare prices set by fee-for-service have a direct impact on the prices paid by insurers throughout the health care system. But one of the most significant changes in the health care delivery system in the past few years has been the shift away from traditional FFS payment methods to managed care arrangements. It has been…
Medicare claims repricing is the application of the contract terms to the billed charges between the hospital or the physician practice and the insurance network. And the bill charges are from the healthcare facility or the physician group. As the “claims” is received, it is sent for adjudication to verify certain claim criteria, and then…