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 Medicare Claims Repricing? Is Medicare Claims Repricing So Hard Anymore?

By pwsadmin | December 22, 2020

Medicare and Medicaid repricing system enables healthcare payers to efficiently manage healthcare provider data and automate claims pricing by leveraging its adaptive, rules-driven architecture. Medicare claims repricing can significantly lower, pre-negotiated rates which providers in the healthcare networks have already agreed.What is Medicare Claims Repricing? Medicare claims repricing is the application of the contract terms to…

Referenced Based Pricing: A Solution for Employers to Cut Health Plan Costs

By pwsadmin | November 26, 2020

Reference based pricing strategy in healthcare is revolutionary. It helps both employers and employees save money by paying reduced aggregate amounts based on a percentage of what Medicare reimburses these providers. It’s truly helpful for them to bend healthcare costs downward.  Let’s Explain the Benefits of Reference Based Pricing Strategy.  With the reference based pricing…

Solution to Drive Compliant and Cost-efficient Medicare Reimbursement Rates Easily and Accurately

By pwsadmin | November 18, 2020

Medicare billing can be arduous and Medicare claims repricing can be challenging. If they are put together and one works on them without proper training, the result can be a loss of revenue. With the use of an easy-to-use, SaaS-based medicare claims repricing tool, an organization can mitigate the entire claims repricing process and optimize…