Improve Your Claims Accuracy Today with CMSPricer’s Edit-Only Approach
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,…
Read More5 Easy & Quick Ways You Can Control Medicare Contract Claim Costs
CMSPricer provides instant Medicare claim repricing information and claims summaries based on the latest Medicare fee-for-service (FFS) rates. With CMSPricer, you can compare payment rates across multiple business lines, service categories, and locations – giving you a valuable benchmark to gauge your data and payment practices against. Paying for Medicare FFS can be confusing and…
Read MoreSaaS-based CMSPricer Can Be Your Valuable Administrative Tool For Medicare Claim Repricing
As a SaaS-based platform, CMSPricer’s Medicare claims repricing platform centralizes clinical, financial, and administrative processes to enable the optimization and delivery of the competitive edge that Third Party Administrators and payers require for cost-effective benefit administrations. This is a web-based application that facilitates the electronic transmission of one of the best medical claims processes by…
Read MoreWorried About Medicare Claim Denials? Check Out How Our SaaS Medicare Claims Editing Tool Can Assist You
In order to control healthcare costs and ensure satisfaction among employers and providers, payers are crucial. Their goal is to process medicare claims as precisely and efficiently as possible to balance these competing objectives. Increasing healthcare costs and stagnant profits mean payers have to make sure medicare claims processing is smooth. If you make any…
Read MoreHow You Can Avoid Rebilling Errors in Medicare Claims?
Are you looking for a Medicare repricing tool that can eliminate your rebilling errors in Medicare claims? Looking for such a tool to provide claim line level detail and summaries of Medicare claims repriced to Medicare rates, easily, quickly, and flawlessly? The Medicare Administrative Contractors (MACs) complain that they often see Medicare claim reports replete…
Read MoreMedicare Claims Repricing Based on Medicare Rates
Physicians and hospitals that accept Medicare reimbursement agree to fixed prices for the services and treatments they provide to Medicare patients. These prices are established by CMS (the Centers for Medicare and Medicaid Services). Prices for those services are typically a fraction of what insurance companies or privately insured patients pay, and they increase by…
Read MoreWhy Do TPAs Need Medicare Repricing Software?
As our medical technologies advance, it’s not surprising why rates for healthcare services are also rising. Therefore, employers are becoming more interested in self-funded insurance programs, such as reference-based pricing models. Self-funded programs are now primarily used by companies with 200 to 400 employees. By taking care of these expenses themselves, smaller companies are now…
Read MoreMedicare Repricing System Built To Improve Your Administrative Processes
By replacing manual procedures and modernizing administrative processes through the centralization of workflows, Third-Party Administrators save a lot of money. As a result, TPAs can re-price all commercial claims at Medicare rates (Reference Based Pricing) at a percentage of the Medicare authorized amount, as well as price all Medicare-based claims. CMSPricer’s SaaS-based Medicare claims repricing…
Read MoreClaims Accuracy is Ensured with CMSPricer’s Edit-Only Approach
Medicare third-party administrators can eliminate manual data entry and centralize workflows to reduce costs. They can re-price all commercial claims based on Medicare rates (Reference Basis Pricing) and rate all Medicare claims based on the Medicare cap. CMSPricer, a software-as-a-service (SaaS) solution, offers payers and third-party administrators a competitive edge by streamlining clinical, financial, and…
Read MoreMedicare Contract Claims Can Be Configured To Your Specific Rate Now
CMSPricer provides Medicare claims repricing information at claim line level and claims summaries based on Medicare fee-for-service (FFS) rates using a SaaS platform. In the healthcare industry, comparing medical claim allowed amounts with Medicare FFS rates is a common practice, since it provides payers with a useful benchmark to gauge their data and payment practices.…
Read MoreMedicare Claims Editing Module Designed to Increase Revenue Up to 25%
Health plans don’t want to fix claims retroactively once they have finalized a claim. A health plan’s claim accuracy rate improves productivity, reduces errors, and is crucial to its success. To improve claim accuracy, health insurance companies need a technology that can integrate easily with all the systems in their IT ecosystem and exchange data…
Read MoreCMSPricer Editing Feature Allows Rebilling of Incorrect Medicare Claims without Redundancy
Medicare repricing systems are designed to enable healthcare payers and auditing firms besides others to streamline the Medicare claims repricing processes. These systems offer a number of advantages, including increased efficiency and improved data accuracy. CMSPricer is one of those Medicare repricing systems that healthcare payers, auditing firms, PPOs, TPA’s, BPO’s, self-funded employers among others…
Read MoreImprove Healthcare Decisions With Medicare Claims Repricing
Healthcare costs are on the rise, and employers are struggling to keep up by finding high medical claims, minimizing them, and understanding how they affect the health plan. As a result of low transparency and complicated relationships among employers, brokers, and bidders, it is increasingly difficult to accurately compare costs across health plans and networks.…
Read MorePayers Can Avoid Redundancy in Rebilling Error-ridden Medicare Claims By Using CMSPricer
The Medicare Administrative Contractors (MACs) report periodically the most common claims errors they encounter. A few examples of the error-driven Medicare claims that occur on claims are as follows that MACs send to the payers. The claim is duplicate in nature. The primary identifier of the referring physician is missing or incorrect. Invalid or inconsistent…
Read MoreSelf-Funding: What Does Medicare Claims Data Have To Do With It?
It is typical for small employers to pay 8% to 18% more for the same plan than their larger counterparts. To reduce some of these costs, employers have moved to a self-funded model for benefits. Because of this, it is becoming more and more important to have accurate claims data in order to create a…
Read MoreEdit-Only Approach in CMSPricer Prevents Overpayments & Underpayments While Ensuring Claim Accuracy
By replacing manual processes and centralizing their workflows, third-party administrators can save money by reducing costs. In turn, TPAs can re-price all commercial claims at Medicare rates (Reference Basis Pricing) and rate all Medicare claims based on the Medicare cap. SaaS-based Medicare claims repricing platform CMSPricer centralized clinical, financial, and administrative processes to provide TPAs,…
Read MoreWhat is the Big Deal About Reference Based Pricing?
With so many insurance options available today, it can be difficult to select the right policy. A fully insured health plan versus an employer-funded health plan is one of the biggest decisions you will have to make as an employer. Traditionally, companies pay premiums to their insurance companies for fully insured plans. Employers who operate…
Read MoreEmerging Considerations for Self-funded Plans and Employers
The self-funded industry has a long history of staying resilient in the face of unpredictable change. As such, the number of changes that have been required to address COVID-19 is not a shock to this sector. Now that we are in the throes of a global pandemic, the long-term consequences are only beginning to come…
Read MoreReference-Based Pricing: The Best Solution to Restrict Healthcare Spending of an Organization
Reference-based pricing has emerged as a tool self-insured organizations are utilizing to combat the growing financial burden of rising healthcare costs across the U.S. By 2022, healthcare costs are expected to rise by another 6%, largely because of rising prices. A recent study found this trend has been consistent since 2009. As a result of…
Read MoreTPA Medicare Claims Repricing System Enhances Administrative Efficiencies
Third-Party Administrators gain significant cost savings by replacing manual procedures and modernizing administrative processes through centralization of their workflows. As a result, TPA’s can re-price all Commercial claims at Medicare rates (Reference Based Pricing) at a percentage of Medicare allowable as well as price all Medicare based claims. CMSPricer’s SaaS-based Medicare claims repricing platform centralizes…
Read More