Medicare Pricing and Contract Management Solutions Made Easy

Most Accurate, Highly Secure and Lowest Cost Solutions on the Market

Why use CMSPricer to re-price and edit your Medicare claims?

No Set Up

Web-based with results returned in seconds priced at 100% of Medicare rates. Hand Key Entry or Auto Batch/EDI Uploads, Easy imports/exports. 

No Hassle

No contracts, No sales people…..pre-pay purchase with volume discounting and easy online payment processing.

Accurate

Frequent engine updates with latest CMS policies and rates to ensure accurate claims pricing. The CMS.Gov typically has a 3 month lag time and incomplete pricing results. We price all PPS types of Institutional and Professional claims including claim editing for Referenced Based pricing.

Security

No PHI or claims data stored. Utilizes contemporary cloud-based security, including EV SSL Certificate, 5HA2, and 2048 bit encryption (strongest on the market). Fully HIPAA and ANSI 837 version 5010 compliant. Every user has their secure login and account. 

Availability

As long as you have access to the Internet, you can run 24/7/365 securely *excluding short windows for system maintenance.

Our Clients

We serve Payers, PPOs, TPA’s, BPO’s, Self-Funded Employers and Auditing Firms.

New Users 5 Claims FREE no commitments

NO SOFTWARE TO INSTALL

NO COMPLEX CONTRACT TO SIGN

USA OWNED AND OPERATED

100% ON-SHORE RESOURCES

ACCURATE SaaS CLAIMS PROCESSING

EASY MANUAL, BATCH OR API Claims Integration Claims ENTRY

Why our clients value us:

Our latest blog update

Repricing Medicare Claims Tool Can Increase Pricing Transparency for Healthcare Providers

By mwccare | August 30, 2023

In the healthcare industry, pricing transparency and accuracy have long been problematic, causing confusion and frustration for patients. The recent CMS report, however, highlights the efforts hospitals and health systems are making to implement price transparency policies.Based on CMS data, 70% of hospitals in 2022 complied with both shoppable service information display requirements and machine-readable…

How Effective is The SaaS-Based Medicare Repricing System, CMSPricer, at Empowering Healthcare Payers?

By mwccare | August 5, 2023

A growing healthcare cost environment demands providing consumers with the right information and tools to make informed healthcare decisions. CMSPricer, an tool that helps beneficiaries understand medical expenses, has received both praise and criticism. We explore here how CMSPricer empowers healthcare payers to make cost-conscious healthcare decisions, ultimately aiming for more transparent and patient-centered healthcare.…

Does Reference-Based Pricing in Healthcare Sacrifice Quality for Price?

By mwccare | July 25, 2023

Most network agreements establish discounts and billed charges in an arbitrary manner. There is not much relationship between them and the actual cost of the procedure, and they can vary widely by location, provider, and many other factors. Reference-Based Pricing (RBP) In order to control rapidly rising healthcare costs, self-insured companies use reference-based pricing (RBP).…