Medicare Pricing and Contract Management Solutions Made Easy

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

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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

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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:

“CMSPricer meets our stringent CMS Medicare claims accuracy requirements for auditing claims from over 50 Medicare Advantage plans. Using the CMSPricer SaaS based tool and interface allows us to effectively batch process with ease and precision. Great partner!”  

Davis-Farr

Our latest blog update

Revolutionizing Healthcare: Unlocking Transparency and Accuracy with CMSPricer’s Medicare Claims Tool

By pwsadmin | November 25, 2023

Navigating the complex world of healthcare pricing has always been a challenge, leaving patients and providers alike frustrated. But thanks to CMSPricer, that may soon become a thing of the past. The latest report from CMS sheds light on the progress hospitals and health systems are making in implementing price transparency policies. In fact, a…

How a SaaS Repricing & Editing Tool Can Minimize Redundancy & Denials in Medicare Billing?

By mwccare | October 29, 2023

Medicare claims are often difficult for payers to process error-free. They frequently receive reports of claim errors from Medicare Administrative Contractors (MACs). Payers Often Commit The Following Types Of Errors. It may appear in MAC messages that MAC cannot process a claim without missing information in their message. Your claim cannot be processed because of…

Reference-Based Pricing Model is Disrupting Healthcare Models: Who Benefits?

By mwccare | October 25, 2023

Healthcare cost containment has changed forever with reference-based pricing (RBP) – although it has come with a lot of disruption. In addition to saving companies a lot of money, reference-based pricing impacts employee satisfaction. Self-funded healthcare refers to employers taking care of their own claims rather than paying for premiums through a carrier. Third-party administrators…