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Milliman’s Medicare Repricer software assigns Medicare-allowable fees to administrative claims data, allowing payers and providers to surface those fees in their enterprise data warehouse. The software includes service-line level detailed claim adjudication outputs and a suite of reporting workbooks to assist with validation and reconciliation. The Medicare Repricer includes inpatient, outpatient, Ambulatory Surgical Center (ASC), and professional claims repricing capabilities, and replicates the Medicare claim adjudication logic including diagnosis-related group (DRG) and ambulatory payment classification (APC) grouping.
The Milliman Medicare Repricer software has a wide variety of applications, including:
If you’d like to use this product, contact us to learn more about Milliman’s Medicare Repricer. You can also download this brochure.
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