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

Medicare Claims Repricing Based on Medicare Rates

By mwccare | May 6, 2022

Physicians and hospitals that accept Medicare reimbursement agree to fixed prices for the services and treatments they provide to Medicare patients. These prices are established by CMS (the Centers for Medicare and Medicaid Services). Prices for those services are typically a fraction of what insurance companies or privately insured patients pay, and they increase by…

Why Do TPAs Need Medicare Repricing Software?

By mwccare | April 29, 2022

As our medical technologies advance, it’s not surprising why rates for healthcare services are also rising. Therefore, employers are becoming more interested in self-funded insurance programs, such as reference-based pricing models. Self-funded programs are now primarily used by companies with 200 to 400 employees. By taking care of these expenses themselves, smaller companies are now…

Medicare Repricing System Built To Improve Your Administrative Processes

By mwccare | April 26, 2022

By replacing manual procedures and modernizing administrative processes through the centralization of workflows, Third-Party Administrators save a lot of money. As a result, TPAs can re-price all commercial claims at Medicare rates (Reference Based Pricing) at a percentage of the Medicare authorized amount, as well as price all Medicare-based claims. CMSPricer’s SaaS-based Medicare claims repricing…