Configuring Contract Claims At Any Specific Rate is Now a Breeze!

Our fully integrated contract configuration tool allows easy configuration for any contract claims at any specific rate with automated pricing based on the predetermined fee-for-service (FFS) loaded contract schedule. This saves time by generating and exporting claim reports and accelerate processes 3x faster. This new feature offers:

  • An end-to-end contract claims configuration functionality

  • Manage and maintain multiple fee schedules with associated networks

  • Easily identify providers, provider organizations, and their relationships

  • Automate your contracts while providing accurate CMS pricing and editing

  • Manage a rate payment increase on any given day (typically annually)

CMSPricer contract configuration module provides time-saving and cost-saving solutions. The management control feature in the module also offers significant cost control leverage.

Step 1- Enter your contract or RBP information and rate


Step 2- Review the rules you loaded


Step 3- Easily setup any sophisticated rule-based sets to allow settings for different providers/facilities, individual services, and within a date range. You can configure to meet your requirements exactly.


Step 4- Price the claims and rules automatically by compiling a claims group by type and then apply the parameters based on your specific requirements.


Step 5- If all claims are not Medicare, utilize the CMSPricer's Fee‑For‑Service module with multiple fee schedules for FFS or PPO networks. Providers of your network can change PPO’s over time, and CMSPricer always selects the correct fee schedule.