Why CMSPricer to re-price your Medicare and Medicaid 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
Every Medicare repricing solution might be different, but almost every single one makes the same mistake by putting the company in jeopardy: it delays in complying with the CMS updates. As a result of delayed CMS update compliance: Inaccurate payment or overpayment risksClaims re-working or readjustingStrained provider relations or increased provider inquiriesHolding claims risks prompt…
In order to navigate the healthcare crisis and economic turmoil resulting from the coronavirus outbreak, many organizations are recalibrating their employee healthcare benefit programs. They are now more focused on finding solutions to keep their team members safe and healthy. Yes, it is also true that many organizations across the country are being compelled to…
Capping health plan expenses is gaining attention. Employers and advisers alike have been buzzing about Medicare reference-based pricing (RBP), which is a relatively new solution for controlling health plan expenses set outside traditional insurance carriers. With Medicare reference-based pricing, employers can get in on the savings too, enabling them to control the costs of medical…