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CMSPricer Can Help Payers Avoid Rebilling Error-Rigged Medicare Claims
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, you…
Adapting Medicare Claims Repricing to Evolving Markets
There is a strong demand for Medicare Advantage plans. On average, Medicare advantage premiums have grown less than those in the marketplaces. It now accounts for about one-third of Medicare enrolment Size of the Market: Approximately one-third (34%) of all Medicare beneficiaries, or 22 million people, are enrolled in Medicare Advantage plans in 2019. Since…
Improve Your Claims Accuracy Today with CMSPricer’s Edit-Only Approach
Administrators of Medicare can reduce costs by eliminating manual data entry and centralizing workflows. They can also save money by re-pricing all commercial claims based on Medicare rates (Reference Basis Pricing) and rating all Medicare claims according to the Medicare cap. Providing payers and third-party administrators with a competitive edge through a software-as-a-service (SaaS) solution,…