CMSPricer's Contract Configuration module enables organizations to automatically price any claim at any specific rate. The tool is easily populated from a spreadsheet so that each provider or facility has a specific assigned rate for each claim and claim type. This includes facilities to identify providers, provider organizations, and their relationships – so that one provider can transfer from one organization to another as of a specific date. It allows facilities to maintain multiple fee schedules and their association to provider organizations. This feature is essential when the fee schedules change over time. For example, the configuration tool can automatically manage a rate payment increase to a provider for 3% on any given day (typically annually) so that no manual process must be implemented for this provider to receive accurate rate increases on an annual basis.
The configuration in CMSPricer also supports the ability to price some claims with FFS and other claims with CMS pricing. The FFS claims can be uploaded and claims will be identified upon processing for automatic pricing based on the pre-determined FFS loaded schedule.