Why use CMSPricer to re-price and edit your Medicare claims?
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 contracts, No sales people…..pre-pay purchase with volume discounting and easy online payment processing.
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.
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.
As long as you have access to the Internet, you can run 24/7/365 securely *excluding short windows for system maintenance.
We serve Payers, PPOs, TPA’s, BPO’s, Self-Funded Employers and Auditing Firms.
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!”
Our latest blog update
Are You Prepared? Discover the Impact of the New Advanced Beneficiary Notice in Effect for Medicare!
A new Advanced Beneficiary Notice (ABN) is now in effect for Medicare. This ABN will help ensure that Medicare beneficiaries are informed of their rights and responsibilities regarding certain services or items requiring prior authorization. The ABN also outlines the potential financial liability associated with such services or items. It is important to review this…
Healthcare costs continue to rise as organizations strive to provide quality care to their employees while managing rising costs. Reference-based pricing (RBP) has received significant attention in recent years. With RBP, employers can regain control over their healthcare spending by challenging the traditional reimbursement model. To assess the potential impact of this pricing model on…
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…