Transforming Your Claims Repricing Process: The Top Benefits of a SaaS-Based System

As the Medicare enrollee population is going to increase from 35% to between 45-55% by 2025, the relationship between payers and providers is often put to the test when addressing Medicare claims from different ends of the payment continuum. A more flexible approach than traditional fee-for-service is needed to meet the new healthcare market requirements, which is why the emerging payment models require a greater collaboration between these two parties to strengthen the complex healthcare environment.

A SaaS-Based Medicare claims repricing system is the perfect solution to overcome the pricing complexities, build a better relationship between payers and providers, and save time, money, and resources. It gives more freedom, keeps data secure, and ensures compliance with CMS updates, making it the ideal tool to combat the struggles of the ever-evolving Medicare landscape.

Medicare claims repricing system

What are the Benefits of a SaaS-based Medicare Claims Repricing System?

1) Ensure Universal Accessibility:

Users can log in from anywhere with an internet connection to monitor Medicare claims on-the-go and see changes in real time with a SaaS-based Medicare claims repricing system. It provides solutions for easy-to-use medical billing workflows across a variety of devices and connects members, providers, and other stakeholders. Using CMSPricer, users can securely access eligibility, provider information, and other configurable fields from their computers, tablets, or smartphones.

2) Improved Accuracy:

CMS policies and rates are frequently updated with SaaS-based solutions for Medicare claims repricing. As a result of this feature, claims pricing is accurate. Pricing results on CMS.Gov are typically incomplete and have a 3-month lag time. With this SaaS-based solution, you can price all types of PPS claims, including Reference-Based pricing, for Institutional and Professional claims.

3) A Higher Level of Security:

Safety of patient records is the biggest concern. With paper-based workflows, keeping PHI data secure is a challenge, while digital record keeping with passwords is the key to protection from potential breaches. Unfortunately, neither of these methods can protect records from other threats such as fires or computer crashes. CMSPricer offers a SaaS-based Medicare claims repricing solution that safeguards all records from any disaster. In the event of a computer crash, records remain safe in the cloud and remain accessible when the computer is up and running again. What sets CMSPricer apart is its commitment to no PHI (Protected Health Information) or claims of data breach, thanks to its advanced cloud-based security features like EV SSL Certificate, 5HA2, and 2048-bit encryption – the strongest on the market. Plus, CMSPricer is fully HIPAA and ANSI 837 version 5010 compliant, offering secure logins and accounts for every user.

In Summary:

Payers can take advantage of automated adjudication of rates, reduce the risk of incorrectly paying claims and batch process with ease and precision, all thanks to a SaaS-Based Medicare claims repricing system. Additionally, a custom interface on the system allows for quick and easy import or export of a claim file for repricing. However, not every SaaS-Based Medicare claims repricing system may offer these essential features, so make sure you check them out before implementation.

Want to learn more about how a SaaS-based Medicare claims repricing system can streamline your business? Let’s fix this discussion.