CMSPricer

PPS stands for Prospective Payment System. It is a reimbursement process in which Medicare payment is made based on predetermined and fixed amounts. Social Security Amendments of 1983 established the PPS system for hospital inpatient services provided to Medicare beneficiaries. In this system, a hospital is given a fixed amount of treatment in the DRG category. The PPS pricer system plays a crucial role to control over-increasing fees of healthcare treatment.  Why PPS is Required: See, the PPS is required to maintain the system to provide ultimate care to the patients. This actually makes the healthcare service providers be responsible to offer quick and quality health care service to their patients without compromising on anything. There is an in-built incentive for providers and that’s why they are subjected to deliver quality care to patients. The health cost estimate is getting higher day by day. That’s why many people have enrolled for different health care policies under pr...

The health insurance service providers always look for advanced systems to remain updated about the CMS policies and rates. CMS always tries its best to maintain medical cost transparency, but CMS policies and rates change multiple times a year, and to update about it, many health insurance providers take the assistance of automated claims pricing systems. There are many benefits of using an automated claim system and these are: Reduced data entry Completeness of application Eliminates need for storage Audit trail Visibility to the customers Identification of fraud claims There are many risks associated with manual claims processing. It takes time and there is a chance of committing errors that can lead to incomplete payment. On the other hand, using an automated claim system can make the whole thing easier and more smooth. With automated software, all things accomplished within a short time and there is no risk of committing errors while claims processing. In the market, there are ma...

Health is one of the greatest assets for a human being. Nowadays almost everyone has health  insurance which provides benefits upto a certain sum. People after the treatment look for reimbursement of money from the health insurance companies. In most of the cases, the beneficiaries are not much aware about the pricing and the CMS policy. This can lead to errors in the claims asked by the beneficiaries which can bring irregularity. But there is a solution to this. There are tools available who can keep you updated with the pricing and the CMS rules such that you can claim the right amount for reimbursement. The CMS Medicare online tools help you to a great deal. The best part is that it is very easy to use and you do not have to install any software for this. They provide very accurate data and help you to decrease your expenditure significantly.  The most effective tool is a SaaS based system with an advanced cloud system. You can avail this service from this tool 24/7 throug...