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Writer's pictureEric Brown

All About Medicare Claims Repricing

With highly secure, accurate, and affordable prices, the CMS pricer tool provides accurate mediclaim pricing, auditing and editing as per mediclaim requirements. Payers are essential for maintaining healthcare cost control and guaranteeing provider and employer satisfaction. In order to balance these conflicting objectives, their purpose is to handle Medicare Claims Repricing as exactly and effectively as feasible.

Why do People Choose CMSPricer?


This is a SaaS-based Medicare claims repricing platform that has been provided by CMS Pricer with the purpose to streamline clinical, financial, and administrative procedures. With the help of this tool, now TPAs and payers will get a competitive advantage.


How to Boost Complicated Batch Claims Efficiency:


Users can quickly enter claims in batches using CMS Pricer. Users can import or export claim files for re-pricing very easily with the custom interface.


Data Protection:


This platform guarantees that no PHI or claims data is stored in addition to being HIPAA and ANSI 837 version 5010 compliant. Users have safe accounts and logins.


Automate Manual Tasks:


The platform not only assists TPAs in reducing manual work, but it also provides a flexible gateway for members and providers to connect, share, and interact.


Realize Accuracy


CMSPricer updates its system with the most recent CMS policies and rates to assure accurate medical claim pricing. All PPS types of institutional and professional claims can be priced by CMSPricer, and claims can also be edited to ensure reference-based pricing is used.


24/7 Online Accessibility


In contrast to classic medical claim processors, which have a working period inside a specific timeframe, the platform allows users to access the system as long as they have Internet connectivity.


TPAs and their support services frequently struggle to recognise and fix problems with the way Medicare claims Repricing are processed. Customer support employees may easily access the SaaS-based platform of CMS Pricer when issues arise. Additionally, customers will benefit from a user-friendly claim interface that enables them to quickly detect problems, fix them, and efficiently process batches of claims.

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