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

What is the Big Deal About Reference Based Pricing?

By mwccare | November 9, 2021

With so many insurance options available today, it can be difficult to select the right policy. A fully insured health plan versus an employer-funded health plan is one of the biggest decisions you will have to make as an employer. Traditionally, companies pay premiums to their insurance companies for fully insured plans.Employers who operate their…

Emerging Considerations for Self-funded Plans and Employers

By pwsadmin | September 16, 2021

The self-funded industry has a long history of staying resilient in the face of unpredictable change. As such, the number of changes that have been required to address COVID-19 is not a shock to this sector. Now that we are in the throes of a global pandemic, the long-term consequences are only beginning to come…

Reference-Based Pricing: The Best Solution to Restrict Healthcare Spending of an Organization

By pwsadmin | September 3, 2021

Reference-based pricing has emerged as a tool self-insured organizations are utilizing to combat the growing financial burden of rising healthcare costs across the U.S. By 2022, healthcare costs are expected to rise by another 6%, largely because of rising prices. A recent study found this trend has been consistent since 2009. As a result of…