How CMSPricer’s Contractor Manager Is Revolutionizing Medicare Repricing for Payers, PPOs, TPAs, and Auditors

Staying compliant with CMS rules and ensuring accurate Medicare repricing can be overwhelming in today’s fast-paced healthcare environment. For payers, PPOs, TPAs, BPOs, self-funded employers, and auditing firms, efficiency and accuracy in contract management are critical. That’s where CMSPricer’s Contract Manager shines, offering a comprehensive SaaS-based solution that significantly streamlines and accelerates the Medicare repricing process.

Faster, More Efficient Repricing with Contract Manager

The Contract Manager feature within CMSPricer allows users to configure claims at specific rates, saving time and reducing errors. Gone are the days of manually entering rates and struggling to maintain multiple fee schedules. With CMSPricer, the entire process is automated, which not only increases efficiency but also improves the accuracy of the claims. The integrated contract configuration tool allows for simple setup and management of fee-for-service (FFS) schedules, making it easier to follow complex CMS regulations.

Simplifying the Complexities of Medicare Repricing

For payers, PPOs, TPAs, and BPOs, managing various networks and fee schedules can be a daunting task. The Contract Manager helps by offering an end-to-end solution for contract claims configuration. By automating the entire repricing process, users can generate claim reports three times faster than traditional methods. This means less time spent on administrative tasks and more time dedicated to strategic decision-making.

With the ability to maintain multiple fee schedules for different networks, including PPO networks, CMSPricer ensures that the right fee schedule is always applied. Whether you’re managing a provider network or working with self-funded employers, CMSPricer keeps everything streamlined, so you never have to worry about choosing the wrong rate for a specific claim.

Key Features of CMSPricer Contract Manager

• Easy Contract Configuration: The step-by-step process guides users through entering contract or RBP (Reimbursement-based Pricing) information and configuring the contract according to specific needs.

• Customizable Rules Setup: The ability to configure sophisticated rule-based sets allows organizations to meet their exact requirements, including different providers, facilities, services, and date ranges.

• Accurate Medicare Pricing: Automatic pricing ensures compliance with CMS guidelines, and the feature adapts to both Medicare and non-Medicare claims, allowing for a mix of fee schedules.

• Rate Payment Flexibility: The system provides the flexibility to manage and increase rate payments at any given time, typically annually, making contract adjustments simple and efficient.

• Cost and Time Savings: By automating these key functions, CMSPricer helps businesses reduce operational costs, minimize human error, and speed up the claim processing workflow.

Managing Complex Fee Schedules with Ease

A standout feature of CMSPricer’s Contract Manager is its ability to manage multiple fee schedules associated with different provider organizations. With an intuitive interface, users can easily identify providers, their organizations, and their relationships with the network. This level of transparency helps organizations avoid costly mistakes when selecting the appropriate pricing schedule for each claim.

The Bottom Line: Efficiency, Accuracy, and Compliance

For any payer, PPO, TPA, BPO, self-funded employer, or auditing firm dealing with Medicare repricing, CMSPricer’s Contract Manager is a game-changer. By automating the complex tasks of contract configuration and Medicare pricing, it offers not just time-saving and cost-saving benefits but also ensures accuracy and compliance with ever-changing CMS rules.

Ultimately, CMSPricer enables organizations to stay ahead in a competitive market by significantly accelerating repricing processes, reducing errors, and driving down operational costs—all while ensuring full regulatory compliance. Whether you’re a payer or a provider organization, CMSPricer ensures that your Medicare repricing activities are more streamlined, more accurate, and far less time-consuming than ever before.

Is your organization ready to simplify Medicare repricing? Let CMSPricer Contract Manager be the solution that transforms your workflow for the better.