About Medicare Repricer
Medicare Repricer is a pricing software from Milliman that supports the management of Medicare reimbursement rates. It provides accurate pricing updates, detailed reporting, and compliance monitoring so healthcare providers can effectively manage their financial performance. The software is designed to assist organizations in staying compliant with Medicare regulations and ensuring they receive appropriate reimbursements for services rendered. Users can simplify their pricing processes while gaining insights into reimbursement trends and compliance requirements. Key capabilities: pricing updates reporting tools compliance monitoring trend analysis user-friendly interface Best for: healthcare organizations that need to manage Medicare reimbursements efficiently.
Medicare Repricer Details
Medicare Repricer's In-App Market Place
Does Medicare Repricer have an in-app market place?
Yes
How many Mini-Apps in the marketplace?
1
Mini Apps
N/A
Pricing Options
Accepted Payment Currencies
USD ($), EUR (€), GBP (£), AUD ($), CAD ($), JPY (¥), CNY (¥), INR (₹), RUB (₽), MXN ($)
Pros & Cons
- 1. Medicare Fee Schedule Replication: The software replicates Medicare claim adjudication logic, including DRG and APC grouping, ensuring accurate repricing based on official Medicare rules.
- 2. Wide Range of Supported Fee Schedules: Supports various Medicare fee schedules, covering inpatient, outpatient, ASC, SNF, physician, DME, lab, ambulance, and other services, providing comprehensive repricing capabilities.
- 3. Service-Line Level Detail: Offers detailed claim adjudication outputs at the service-line level, providing granular insights into pricing and reimbursement.
- 4. Reporting Workbooks: Includes reporting workbooks to assist with validation and reconciliation, simplifying data analysis and ensuring accuracy.
- 5. Multiple Uses: Offers a variety of applications, including reference pricing, standardized fee schedules, capitation analysis, and payment integrity checks, making it a versatile tool.
- 6. Enables "Percent of Medicare" Comparisons: Facilitates comparisons to Medicare-allowed amounts, providing easy-to-understand price relationships.
- 7. Supports Transition to Medicare-Based Fee Schedules: Helps calculate providers' current percentage of Medicare, simplifying the transition to Medicare-based fee schedules.
- 8. Capitation Analysis: Allows repricing data to understand the value of services under capitation contracts.
- 9. Payment Integrity Checks: Enables independent repricing to verify actual payments and adjudication results, helping identify potential overpayments or errors.
- 10. Established Firm: Milliman is a well-established and reputable actuarial and consulting firm, lending credibility to the software.
- 1. Limited Information on Integration: While the brochure is mentioned, the website lacks specific details about integrating the Medicare Repricer with existing systems (e.g., claims processing, data warehouses). Integration complexity is a common concern.
- 2. Focus on Medicare: The software is specifically designed for Medicare repricing. Its applicability to commercial or other payer arrangements is unclear.
- 3. Potential Complexity: Replicating Medicare's complex payment rules can lead to complex software, potentially requiring specialized training and expertise to use effectively.
- 4. Dependence on Milliman: Organizations become dependent on Milliman for their Medicare repricing. Any issues with Milliman's systems could potentially disrupt operations.
- 5. Limited Information on Data Updates: The website doesn't explicitly address how frequently the software is updated to reflect changes in Medicare fee schedules and regulations. Timely updates are crucial for accuracy.
- 6. No Mention of Cloud vs. On-Premise: The website doesn't specify whether the software is cloud-based, on-premise, or offers a hybrid approach. This is important information for IT departments.
- 7. Lack of User Interface Details: The website doesn't provide screenshots or details about the user interface, making it difficult to assess the software's usability.
Medicare Repricer's Support Options
Email Address
support@medicarerepricer.comContact
877-397-2928