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 Contract Claims Can Be Configured To Your Specific Rate Now

By mwccare | March 3, 2022

CMSPricer provides Medicare claims repricing information at claim line level and claims summaries based on Medicare fee-for-service (FFS) rates using a SaaS platform. In the healthcare industry, comparing medical claim allowed amounts with Medicare FFS rates is a common practice, since it provides payers with a useful benchmark to gauge their data and payment practices.…

Medicare Claims Editing Module Designed to Increase Revenue Up to 25%

By mwccare | March 1, 2022

Health plans don’t want to fix claims retroactively once they have finalized a claim. A health plan’s claim accuracy rate improves productivity, reduces errors, and is crucial to its success. To improve claim accuracy, health insurance companies need a technology that can integrate easily with all the systems in their IT ecosystem and exchange data…

CMSPricer Editing Feature Allows Rebilling of Incorrect Medicare Claims without Redundancy

By mwccare | January 22, 2022

Medicare repricing systems are designed to enable healthcare payers and auditing firms besides others to streamline the Medicare claims repricing processes. These systems offer a number of advantages, including increased efficiency and improved data accuracy. CMSPricer is one of those Medicare repricing systems that healthcare payers, auditing firms, PPOs, TPA’s, BPO’s, self-funded employers among others…