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

Reduce Your Company’s Healthcare Costs by Adopting a Reference-based Pricing Model

By mwccare | February 10, 2023

Medicare repricing can help companies reduce their healthcare costs by utilizing a reference-based pricing model. In this model, the reference price is set by Medicare, and the provider is reimbursed at the lower of the billed amount or the reference price. This can help reduce the cost of care for companies, as Medicare reimbursement rates…

Medicare Claims Editing Module Increases Revenue by 25%

By mwccare | February 6, 2023

When health plans have finalized claims, they don’t want to retroactively fix them. It is vital to a health plan’s success to improve claim accuracy and reduce errors. An IT ecosystem that can integrate easily and exchange data in real-time is essential for health insurance companies to improve claim accuracy. With real-time data, payors can…

Is Reference-Based Pricing a Cost-Cutting Tool for Employers?

By mwccare | January 25, 2023

Cost-caps for health plans are gaining popularity. A relatively new solution to controlling health plan expenses, Medicare reference-based pricing (RBP), has been buzzing among employers and advisers alike. Referral-based pricing from Medicare lets employers save too, allowing them to control short- and long-term health care costs. In spite of all the buzz about reference-based pricing,…