The Pricing and Coding (PCS) contract includes new work for claims grouping and coding services and a continuation of Bellese’s claims pricing modernization work from the previous contract.
FREMONT, CA: Medicare claims payment is based on several factors, including fee schedules, price computations, provider type, geographic location, and payment model participation. The Centers for Medicare & Medicaid Services (CMS), a federal agency that administers major healthcare programs in the U.S., has awarded Bellese Technologies, a human-centered service design company, the Medicare Payment System Modernization (MPSM) PCS contract. Bellese has been working with CMS, the United States Digital Service (USDS), and other MPSM ecosystem stakeholders for the past three years to update the decades-old, mainframe-based legacy payment systems gradually. The PCS contract includes new work for claims grouping and coding services and a continuation of Bellese’s claims pricing modernization work from the previous contract.
“We have been fortunate to be an MPSM pioneer in the application of user research, product management, service design, and the build-out of a cloud-based architectural runway required to support the modern pricer tools,” said Pam Offutt, Partner and CEO, Bellese.
The Pricing and Coding Services contract is part of CMS’s overall strategy to enable providers and vendors to support the claims submission process with responsive, accurate, and accessible services. CMS’ capacity to promptly accept policy changes and efforts that impact the modern services will aid claim rates.
“Our goal is to give CMS the flexibility they need to quickly provide accurate pricing and coding services to the Medicare community.” John duClos, Partner and CTO, Bellese added, “the use of a global API specification and a common component strategy contributed to the progressive conversion and modernization of the pricer product. We are excited to build on our success and grateful to continue this important legacy system modernization work with CMS.”