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

Unlocking Hidden Revenue: Seizing the Reimbursement Opportunity of Transfer DRG Overpayments

By mwccare | June 7, 2023

The complex world of healthcare reimbursement poses numerous challenges for hospitals and healthcare organizations. Transfer Diagnosis Related Groups (DRG) overpayments are often overlooked. Healthcare providers can unlock hidden revenue streams by understanding the intricacies of Transfer DRG overpayments. To explore Transfer DRG overpayments, and learn how organizations can leverage this valuable reimbursement opportunity, we will…

Revolutionize Your Medicare Advantage Claims Repricing Business with CMSPricer

By mwccare | May 15, 2023

If you’re in the Medicare Advantage claims repricing business, you know that pricing can be a challenge. With the ever-changing landscape of healthcare, it can be difficult to keep up with the latest pricing trends and regulations. That’s where CMSPricer comes in – an innovative SaaS-based Medicare repricing platform that empowers Medicare Advantage claims repricers…

Why Healthcare Providers Should Utilize a Repricing Medicare Claims Tool for Greater Pricing Transparency

By mwccare | April 28, 2023

The healthcare industry has long struggled with pricing transparency and accuracy, leading to confusion and frustration for patients. However, the recent CMS report highlights the efforts of hospitals and health systems to implement price transparency policies to help patients understand their costs. According to CMS, a higher percentage of hospitals in 2022 (70%) complied with…