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

Enhance Administrative Efficiency with TPA Medicare Claims Repricing

By mwccare | January 13, 2023

With the centralization of their workflows, third-party administrators can save significant amounts by replacing manual procedures with automated ones. So, TPAs can re-price all commercial claims at Medicare rates (Reference Based Pricing) at a percentage of Medicare allowable, as well as price all Medicare claims.SaaS-based CMSPricer’s Medicare claims repricing platform optimizes clinical, financial, and administrative…

Aspects to Consider When Taking Advantage of Medicare’s Prospective Payment System (PPS)

By mwccare | December 16, 2022

In a time when healthcare costs are rising at an alarming rate, prospective payment systems (PPS) are one of the most important policy tools. Using a methodology that shapes providers’ incentives, PPS has gained traction in health policy-making in relation to the government’s effort to expand health coverage. How does PPS Work? Patient care is…

CMSPricer Can Help Payers Avoid Rebilling Error-Rigged Medicare Claims

By mwccare | November 28, 2022

In terms of Medicare claims errors, Medicare Administrative Contractors (MACs) provide a periodic report on the ones they encounter most frequently. These are some examples of error-driven Medicare claims that MACs send to payers. If there is missing information, the payment or processing of the claim is not possible. Since this claim cannot be processed,…