Medicare Pricing and Contract Management Solutions Made Easy

Most Accurate, Highly Secure and Lowest Cost Solutions on the Market

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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

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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:

“CMSPricer meets our stringent CMS Medicare claims accuracy requirements for auditing claims from over 50 Medicare Advantage plans. Using the CMSPricer SaaS based tool and interface allows us to effectively batch process with ease and precision. Great partner!”  

Davis-Farr

Our latest blog update

Unlock the Secrets to Maximizing Medicare’s Prospective Payment System (PPS)

By pwsadmin | January 13, 2024

Amidst the ever-growing costs of healthcare, the prospective payment system (PPS) has emerged as a vital tool for the government’s mission to expand coverage. This innovative methodology reshapes the incentives of providers, ensuring efficient and effective patient care. But what exactly is PPS and how does it operate? In essence, this system promotes the delivery…

Revolutionizing Pricing Transparency in Healthcare: The Power of CMSPricer for Medicare Claims

By pwsadmin | January 5, 2024

Repricing Medicare claims has long been a thorn in the side of healthcare providers, causing a tangled web of confusion and frustration for patients. But fear not, as the recent CMS report brings a glimmer of hope. It shines a spotlight on the efforts of hospitals and health systems to increase pricing transparency and accuracy,…

Unlocking the Power of Informed Healthcare: An Exploration of CMSPricer’s Effectiveness in Empowering Payers

By pwsadmin | December 11, 2023

In a world of ever-rising healthcare costs, knowledge is power for both patients and payers. With CMSPricer, a SaaS-based Medicare repricing system, healthcare payers can harness this power and make more cost-conscious decisions. But how effective is CMSPricer truly at empowering payers in this crucial quest for transparency and patient-centered care? A Game-Changing Tool Navigating…