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Medicare and Editing 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 COMPLICATED CONTRACT TO SIGN

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

Reference Based Pricing Explained: Let’s Take a Look Around

By pwsadmin | April 22, 2020

With the continuous rise of healthcare costs, employers are searching for new ways to reduce those costs, without compromising healthcare quality for their employees. It drives them to explore and adopt viable strategies to mitigate the impact. One of those strategies, which is not so new but gaining in popularity as a cost containment strategy…

See How a SaaS-Based Medicare Claims Re-Pricing Tool Can Save Payers Time and Money by Not Overpaying Claims

By pwsadmin | April 9, 2020

More than 17 million, or 31% of the rapidly growing group of Medicare recipients, have chosen to enroll in Medicare Advantage plans offered by private payers. Competition is, therefore, increasing among payers as they all endeavor to expand into new markets to capture a larger share of this growing population and the associated healthcare funding.…

Is Reference Based Pricing Healthcare Truly Beneficial?

By pwsadmin | October 24, 2019

In the present day, the cost of healthcare services is rising continuously, making it harder for the common people to avail of the premium medical services. However, as it is said – where there is a problem, there is a solution as well, and in this case, the solution is healthcare insurance plans. By investing…