SaaS-based CMSPricer Can Be Your Valuable Administrative Tool For Medicare Claim Repricing

As a SaaS-based platform, CMSPricer’s Medicare claims repricing platform centralizes clinical, financial, and administrative processes to enable the optimization and delivery of the competitive edge that Third Party Administrators and payers require for cost-effective benefit administrations. ‌This is a web-based application that facilitates the electronic transmission of one of the best medical claims processes by allowing providers to deliver a claim that is ready for Medicare repricing by the related TPAs.

Why Should You Use‌ ‌CMSPricer?

SaaS-based CMSPricer continuously updates CMS pricing rules and policies faster than the CMS.Gov PC Pricer tool. It provides accurate CMS Medicare rates,‌ ‌enabling TPAs‌ ‌to:

Get Rid of Manual Work: 

The CMSPricer program not only helps TPAs reduce their manual workloads, it also enables members and providers to communicate, share data, and connect‌ ‌in‌ ‌real-time.

Improve the Efficiency of Complex Batch Claims:

CMSPricer’s batching feature allows users to enter claims ‌easily. ‌ With the custom interface, users can import and export claim files for re-pricing in a simple manner. 

Maintain‌ ‌Accuracy:

To remain compliant with CMS policies and rates, CMSPricer keeps its system up-to-date. ‌As opposed to CMS.Gov, which has a 3 month lag time and incomplete pricing results, CMSPricer has been designed‌ ‌to‌ ‌price‌ ‌all‌ ‌PPS types‌ ‌of‌ ‌institutional‌ ‌and‌ ‌professional‌ ‌claims,‌ ‌including‌ ‌the‌ ‌editing‌ ‌of claims‌ ‌for‌ ‌referenced-based‌ ‌pricing. ‌In order to audit Medicare Advantage claims from over 50 plans, CMS Pricer complies with the CMS Medicare claims accuracy requirements. ‌This means that batch processing will be easy and precise. 

Get Access to the System 24×7:

The CMSPricer system runs 24/7/365, excluding short service windows for system maintenance, unlike legacy medical claims processors that are time-limited.

Keeping your Data Safe

CMPricer complies with modern cloud-based security standards, including EV SSL Certificates, 5HA2 authentication, and 2048 bits of encryption (the strongest‌ ‌on‌ ‌the‌ ‌market). ‌As one of the best SaaS-based medical claims processors, CMSPricer guarantees privacy by ensuring no PHI or claims information‌ ‌is‌ ‌stored. ‌All users are logged in securely from their personal accounts. 

In Conclusion:

The TPAs and the support functions can have a tough time identifying and modifying Medicare claims processing issues. ‌In the event of a problem, CMS Pricer’s SaaS-based platform gives easy access to its customer support staff. ‌In addition, clearly defined claims interfaces facilitate the identification and correction of issues rapidly, as well as the effective processing of ‌batch‌ ‌claims‌ ‌with‌ ‌ease‌ ‌and‌ ‌precision. 

As a SaaS solution, CMSPricer is the right solution for TPAs, payers, PPOs, BPOs,‌ ‌self-funded‌ ‌employers,‌ ‌and‌ ‌auditing‌ ‌firms. ‌ Unlike other solution providers, you’re able to buy directly and complete a contract within 15 minutes. 

Sounds interesting? Contact us TODAY!