Why Do TPAs Need Medicare Repricing Software?
As our medical technologies advance, it’s not surprising why rates for healthcare services are also rising. Therefore, employers are becoming more interested in self-funded insurance programs, such as reference-based pricing models. Self-funded programs are now primarily used by companies with 200 to 400 employees. By taking care of these expenses themselves, smaller companies are now looking to reduce healthcare and benefit costs.
TPA Management Medicare Repricing Software
The increasing number of self-funded companies means that the need for administrative service also tends to rise. The majority of these companies aren’t capable of handling healthcare-related processes such as electronic data interchange (EDI), provider contracting, and claims repricing. Third-party administrators (TPAs) may be needed by some self-funded companies. It remains to be seen how TPAs can meet these growing demands.
End-to-end SaaS-based Medicare Repricing System
An employer can help you overcome a medical crisis by providing you with a self-funded reference-based plan so that you can access health benefits or short-term disability benefits.
Benefits of Using Medicare Repricing Software
With a SaaS-based Medicare repricing software , you can easily store and process your business data, save you from negative impacts of delayed payments, resulting in inaccurate payment or overpayment, reworking on Medicare claims, strained provider relations, faster claims mitigation, besides as follows:
Browser-based medicare pricier software enables its users to automatically re-price their clients’ medicare data, configure specific rules for different clients like contract claims, manage and maintain multiple fee schedules with associated networks, manage a rate payment increase on any given day, thereby saving TPAs time and cost.
Streamlined Batch Claims:
CMSPricer allows users to batch claims easily. By using the customized interface, they will be able to import or export claim files so easily for re-pricing.
CMSPricer ensures that its system stays up-to-date with current CMS policies and rates so that accurate medical claim pricing is guaranteed. Contrary to CMS.Gov, which has a 3 month lag time and incomplete pricing results, CMSPricer is built to price all PPS types of institutional and professional claims, as well as edit the claims for reference-based pricing. Over 50 Medicare Advantage plans are audited by CMSPricer in compliance with CMS Medicare claims accuracy requirements. This means that batch processing is simple and precise.
By implementing CMSPricer medicare pricer software, you’re assured of foolproof data security. Its compliance with the EV SSL Certificate, 5HA2, and 2048 bit encryption for its cloud-based solution and HIPAA and ANSI 837 version 5010 guarantees data security of the users. As well as, user-specific login keeps one user separated from another, thanks to no PHI or claims data storage.
TPAs and self-funded employers can use CMSPricer’s easy-to-use SaaS-based Medicaid and Medicare repricing system to manage claims more effectively. Using this platform, payers, PPOs, TPAs, BPOs, self-funded employers, and auditing firms can get paid faster and reduce their workload.
We can show you how our Medicare pricer software can help you save an average of 90% on Medicaid and Medicare claim repricing.