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

Reference-Based Pricing Model is Disrupting Healthcare Models: Who Benefits?

By mwccare | October 25, 2023

Healthcare cost containment has changed forever with reference-based pricing (RBP) – although it has come with a lot of disruption. In addition to saving companies a lot of money, reference-based pricing impacts employee satisfaction.Self-funded healthcare refers to employers taking care of their own claims rather than paying for premiums through a carrier. Third-party administrators (TPAs)…

How to Take Advantage of Medicare’s Prospective Payment System (PPS)

By mwccare | September 15, 2023

A prospective payment system (PPS) is an important policy tool at a time when healthcare costs are rising alarmingly. In relation to the government’s effort to expand health coverage, PPS has gained traction using a methodology that shapes providers’ incentives. What is PPS and How Does it Work? Through the Prospective Payment System, patient care…

Repricing Medicare Claims Tool Can Increase Pricing Transparency for Healthcare Providers

By mwccare | August 30, 2023

In the healthcare industry, pricing transparency and accuracy have long been problematic, causing confusion and frustration for patients. The recent CMS report, however, highlights the efforts hospitals and health systems are making to implement price transparency policies. Based on CMS data, 70% of hospitals in 2022 complied with both shoppable service information display requirements and…