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
The Medicare Advantage program seems to be thriving. Premium growth in Medicare advantage has been far lower on average than in the marketplaces. Enrolment has continued to increase, now accounting for about one-third of Medicare enrolment. Market Size: In 2019, one-third (34%) of all Medicare beneficiaries, which include 22 million populations, are enrolled in Medicare…
The U.S. spends over $2.8 trillion on healthcare and an estimated 30% is waste! Along with the rapidly-rising healthcare expenses in the country comes a surprising level of inefficiency and waste. Total waste of healthcare expenses tends to cross over $840 billion each year. Inefficient claims processes, administration plans, and non-compliance with the latest CMS…
At times, the relationship between payers and providers turns hostile while addressing the Medicare claims from different ends of the payment continuum. Fee-for-service has been a solution, but today’s healthcare market requirements demand a more flexible approach to meet the needs of the growing Medicare enrollees from the current 35% to between 45-55% by 2025.…