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Payers Can Avoid Redundancy in Rebilling Error-ridden Medicare Claims By Using CMSPricer
The Medicare Administrative Contractors (MACs) report periodically the most common claims errors they encounter. A few examples of the error-driven Medicare claims that occur on claims are as follows that MACs send to the payers. The claim is duplicate in nature.The primary identifier of the referring physician is missing or incorrect.Invalid or inconsistent place of…
Self-Funding: What Does Medicare Claims Data Have To Do With It?
It is typical for small employers to pay 8% to 18% more for the same plan than their larger counterparts. To reduce some of these costs, employers have moved to a self-funded model for benefits. Because of this, it is becoming more and more important to have accurate claims data in order to create a…
Edit-Only Approach in CMSPricer Prevents Overpayments & Underpayments While Ensuring Claim Accuracy
By replacing manual processes and centralizing their workflows, third-party administrators can save money by reducing costs. In turn, TPAs can re-price all commercial claims at Medicare rates (Reference Basis Pricing) and rate all Medicare claims based on the Medicare cap. SaaS-based Medicare claims repricing platform CMSPricer centralized clinical, financial, and administrative processes to provide TPAs,…