CMSPricer Can Help Payers Avoid Rebilling Error-Rigged Medicare Claims

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,…

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Adapting Medicare Claims Repricing to Evolving Markets

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…

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