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

Uncovering the Hidden Gems: The Power of Claims Analytics in Revolutionizing Healthcare

By pwsadmin | April 25, 2024

In the world of healthcare, claims denials are often seen as a necessary evil, draining revenue and causing significant strain on a practice’s financial stability. But what if there was a solution that could minimize these denials and maximize profits? Enter claims analytics.Join us on a journey to discover the untapped potential of claims analytics…

Decoding the Complexity of Medicare Repricing: Strategies, Players, and Innovations

By pwsadmin | April 17, 2024

Medicare repricing refers to the process by which the cost of medical claims is repriced to ensure that insurance providers can manage their payouts more efficiently while still covering the necessary medical procedures for insured individuals. This process is particularly relevant in the context of Medicare and preferred provider organization (PPO) plans. Given the backdrop…

Streamlining the Claim Process: A Revolutionary Solution for Medical Billing Efficiency

By pwsadmin | April 9, 2024

Efficient and accurate claim processing is crucial for the success of medical billing. With the passage of the Health Information Portability and Accountability Act (HIPAA) in 1996, electronic claims submission became the standard for the healthcare industry. Today, over 92% of healthcare providers in the United States use this method, recognizing its superior accuracy, efficiency,…