Third-party administrators can save a lot of money by automating manual processes with the centralisation of their operations. TPAs can price all cms medicare claims processing manual and re-pricing all commercial claims at Medicare rates (Reference Based Pricing) at a percentage of Medicare Allowable.
SaaS-based Medicare claims repricing platforms that are being offered by service providers like CMS Pricer help in streamlining clinical, financial, and administrative procedures to give TPAs and payers a competitive advantage. One of the greatest claims processes is used by the service provider is to allow providers to communicate their medical claims to the TPAs electronically.
Benefits for Businesses Using CMS Pricer
This SaaS-based, scalable platform helps in enabling TPAs to make correct CMS Medicare rates and pricing decisions.
Automation of Manual Tasks
CMS Pricer not only assists TPAs in reducing manual work but also provides a flexible gateway for members and providers to connect, share, and interact. T also helps in boosting complicated batch claims efficiency. Now, users can quickly enter claims in batches using CMS Pricer. Users can easily import or export claim files for re-pricing with the custom interface.
Realise Accuracy
CMSPricer updates its system with the most recent CMS policies and rates to ensure 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. Incomplete pricing results and a 3-month lag time are usual for CMSGov. CMSPricer complies with stringent CMS regulations for CMS medicare claims processing manual accuracy in order to audit claims from more than 50 Medicare Advantage plans. Batch processing will be simple and accurate as a result.
24/7 Online Accessibility
In contrast to classic medical claim processors, which have a working period inside a specific timeframe, CMS Pricer allows users to access the system as long as they have Internet connectivity. The system is, therefore, accessible 24/7/365, except during brief maintenance windows.