More than 17 million, or 31% of the rapidly growing group of Medicare recipients, have chosen to enroll in Medicare Advantage plans offered by private payers. Competition is, therefore, increasing among payers as they all endeavor to expand into new markets to capture a larger share of this growing population and the associated healthcare funding.
How Payers Succeed?
Entering new markets and attracting new participants requires a CMS re-pricing solution that can ensure accurate claims pricing in compliance with the latest CMS policies and rates. Ensuring that accuracy and compliance without automation technology can be arduous, time-consuming, and a costly process by paying claims accurately the first time.
Utilize SaaS and Cloud:
One strategy for improving the process of creating CMS compliant data is to leverage cloud-based Software-as-a-Service (SaaS) technologies that are designed to integrate with existing systems and technologies for re-pricing of Medicare and Medicaid claims. That will also accelerate the delivery process while ensuring the protection of member private health information (PHI).
What Advantages Do You Expect a SaaS-based CMS Re-Pricing System Can Provide You?
If you are a healthcare payer, TPA, healthcare BPO, self-funded employer, or health insurance auditing firm, you are advised to look for a robust CMS re-pricing tool that can streamline the process of Medicare and Medicaid claims re-pricing. It should have built-in CMS approved models and is updated with the latest CMS policies and rates to ensure accurate claims pricing. The system should enable you to edit data, without having to ask for IT expertise. Rather, that system should enable you to access easy-to-use editing tools to enter or change data.
What CMS Re-Pricing Tool Do Experts Recommend?
In addition to providing all of those solutions. CMSPricer can automate the entire re-pricing workflow, batch claims processing effectively in just 3 easy steps, and meet the stringent CMS Medicare claims accuracy requirements for auditing claims from over 50 Medicare Advantage plans. It can price all PPS types of institutional and professional claims including claim editing for referenced-based pricing. CMSPricer also allows its users to import/export claim files for re-pricing so easily with their custom interface.
Let’s See What More Benefits You Can Leverage from CMSPricer:
- Users can perform CMS re-pricing without having to install any software
- Users need not to sign any complicated contract unlike needing to do with several other solution providers
- 5 Free claims pricing for new users
- Accurate SaaS claim processing guaranteed
- Easy manual, batch or EDI claims entry
- Update pricing rules faster
Cost-Saving Opportunity for CMSPricer Clients:
CMSPricer users can also optimize costs by availing of their volume-based tiered plans. There are three plans and all of them are volume discounted to offer the best pricing with the highest volume. If users choose multiple plans, they can optimize costs more. At the same time, CMSPricer will keep displaying clients’ balances to let them know exactly how many claims they have in their account upon return.
Are you looking for such a SaaS-based Medicare claims re-pricing tool? CMSPricer has all these solutions to simplify and streamline your Medicare claims re-pricing requirements and more!
Click here and fix a FREE digital consultation with CMSPricer experts.