![]() ![]() ![]() Easy identification of providers and provider organizations.Multi-fee schedule and network maintenance.A complete solution for organizing and customizing contract claims.As a result of this new feature, you will be able to: The generation and exporting of claim reports save time, and processes can be accelerated three times more quickly. You can customize the contract schedule using its automated pricing-based solution based on the predetermined fee-for-service (FFS). You can configure any contract claim in CMSPricer by using the Contract Configuration feature. With CMSPricer, you can decode the Medicare FFS benchmarks that are hidden inside the “black box.” You will also be able to determine how your medical claims payments compare to Medicare FFS rates, identify improvement areas, create pricing assumptions, negotiate more competitive provider contracts, validate internal payment procedures, and establish new capitation arrangements with CMSPricer.Ī service with unfavorable payment rates, for example, may reveal discrepancies between contracted and actual rates. There can be a nuance in the logic and outcomes. By using CMSPricer, you can compare payment rates across several categories, locations, and business lines.Ī complex set of rules govern Medicare FFS payments, which are subject to frequent changes. A common practice in the healthcare industry is to compare medical claim allowed amounts with Medicare FFS rates to gauge payers’ data and payment practices. By analyzing Medicare reimbursement data at the claim line level, CMSPricer provides Medicare fee-for-service (FFS) rate-based claims summaries. ![]()
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