CMSPricer

Medicare and Medicaid repricing systems make healthcare payers capable to efficiently manage healthcare provider data and automate claims pricing by leveraging its adaptive, rules-driven architecture. Medicare claims repricing’s purpose is to reduce, pre-negotiated rates to providers in the healthcare networks.  What is Medicare Claims Repricing?  Medicare claims repricing refers to the application of the contract terms to the billed charges. Contract terms mean the contract between the hospital system or physician practice and the insurance network.  The billed charges are from the hospital system or the physician group.   How Does Medicare Claims Repricing Work? There are numerous ways for Medicare claims repricing. Many claims repricing strategies are there for different types of plans. The preferred provider organization (PPO) for health insurance claims repricing is among the most commonly used solutions. In this solution, a fixed fee structure is applied to...

  Health insurance is an important aspect that should be considered by individuals and organizations to minimize the financial burdens that may arise due to medical emergencies. And today, with a large number of people coming up for health insurance plans, the insurance companies are offering more options of policies so that the customers can find the policies suiting their specific coverage requirements and benefits. Furthermore, there are different types of tools that are available online these days that make it easier for the users to compare between two or more health insurance plans and choose the one that suits them better. Let’s Take a Close Look at the Advantages of Using a Medicare Pricing Tool? Such a tool is also known as the Medicare Outpatient Procedure Price Lookup tool and this tool mainly serves the purpose of comparing Medicare payments and copayments for some medical and surgical procedures by the customers. These procedures are performed in hospital outpatient d...