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
In terms of Medicare claims errors, Medicare Administrative Contractors (MACs) provide a periodic report on the ones they encounter most frequently. These are some examples of error-driven Medicare claims that MACs send to payers. If there is missing information, the payment or processing of the claim is not possible. Since this claim cannot be processed,…
There is a strong demand for Medicare Advantage plans. On average, Medicare advantage premiums have grown less than those in the marketplaces. It now accounts for about one-third of Medicare enrolment Size of the Market: Approximately one-third (34%) of all Medicare beneficiaries, or 22 million people, are enrolled in Medicare Advantage plans in 2019. Since…
Administrators of Medicare can reduce costs by eliminating manual data entry and centralizing workflows. They can also save money by re-pricing all commercial claims based on Medicare rates (Reference Basis Pricing) and rating all Medicare claims according to the Medicare cap. Providing payers and third-party administrators with a competitive edge through a software-as-a-service (SaaS) solution,…