Medicare Pricing 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 COMPLEX CONTRACT TO SIGN

USA OWNED AND OPERATED

100% ON-SHORE RESOURCES

ACCURATE SaaS CLAIMS PROCESSING

EASY MANUAL, BATCH OR API Claims Integration Claims ENTRY

Why our clients value us:

Our latest blog update

CMSPricer Can Help Payers Avoid Rebilling Error-Rigged Medicare Claims

By mwccare | November 28, 2022

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,…

Adapting Medicare Claims Repricing to Evolving Markets

By mwccare | November 23, 2022

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…

Improve Your Claims Accuracy Today with CMSPricer’s Edit-Only Approach

By mwccare | October 13, 2022

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,…