Medicare + UCR Repricing

Maintaining reimbursement compliance and re-pricing claims is a challenge. There is no consistent method in the healthcare industry. Some policies are built around Medicare, UCR, State Medicaid or a combination. To make it worse most healthcare organizations are stuck with confusing, cumbersome and costly data management .

Real Time, Accurate and Comprehensive Pricing

Context offers real-time reference-based pricing in the cloud with our DecisionPoint Reference-Based Pricing System. Accessible via a real-time web service or through a batch process, pricing mechanisms are maintained by our pricing experts. It’s updated weekly for you. There's no data to download or manage. Real-time Pricing is part of our Payment Integrity Platform.

Our real-time, cloud based pricing includes:

  • Medicare’s Prospective Payment Systems (PPS) are fully automated
  • UCR (general and Medicare gap use)
  • Customizable requests for a percentage of Medicare applied (i.e. 125% Medicare)
  • Rules to support schedule and PPS application based on claim type