The rising healthcare services’ costs have made it more necessary to obtain a medical insurance policy to ensure that you can afford the best medical treatments and facilities in times of medical emergencies.
Reprice and Edit Medicare and Medicaid Claims by Using the CMS PC Pricer Tool
1. Reprice and Edit Medicare and Medicaid Claims by
Using the CMS PC Pricer Tool
The rising healthcare services’ costs have made it more necessary to
obtain a medical insurance policy to ensure that you can afford the best
medical treatments and facilities in times of medical emergencies.
When an insured patient gets admitted to the hospital, a medical claim is
prepared by the physicians and the hospital authorities listing all the
medical services offered to the patient during his/her stay in the hospital.
After the patient gets discharged from the hospital, this medical claim is
then submitted to the insurance payer requesting reimbursement. This
claim is then reviewed and edited if necessary to modify the errors (if
there are any) before finally reimbursing the claim amount. This task is
accomplished today with the help of some advanced tools that make the
process very simple, precise, and hassle-free. Such a tool is the CMS PC
Pricer software application, which can be accessed online and provides
precise results.
Why is it Necessary to Review
and Edit Medical Claims?
Human errors can occur while
preparing a medical claim so,
reviewing the claim is very
important to make sure that it is
error-free. During the claim review
process, certain important details
are checked, such as whether the
claim has been prepared and sent
within the time limit of the payer
or not; it is also ensured that no
non-covered medical services
have been billed; medical services
and diagnosis codes have been correctly mentioned, and other details.
2. Why is it So Beneficial to Use the CMS PC Pricer Tool to Reprice and
Edit Medical Claims?
The PC Pricer is a very user-friendly option when it comes to repricing and
editing Medicare and Medicaid claims in the most precise and effortless
way. No setup is required to use this tool, it gives super-fast web-based
results with the utmost data accuracy, and can be accessed round the clock
with an internet connection. It takes frequent engine updates as per the
change in the latest CMS rates and policies. All types of PPS claims
including institutional and professional claims are edited and repriced as
well as claims editing for Reference Based Pricing can also be done.