The Centers for Medicare & Medicaid Services (CMS) recently awarded Bellese Technologies the Medicare Payment System Modernization (MPSM) Pricing and Coding Services (PCS) contract. For the past three years, Bellese has worked with CMS, the United States Digital Service (USDS), and stakeholders in the MPSM ecosystem to incrementally modernize the decades-old, mainframe-based legacy payment systems. The Pricing and Coding Services contract is a continuation of the claims pricing modernization work that Bellese accomplished on the preceding contract and includes new work for claims grouping and coding services.

Medicare claims payment determination takes numerous variables into consideration, such as fee schedules, price calculations, geographic location, provider type, and payment model participation. The Pricing and Coding Services contract is part of CMS’ holistic approach to give responsive, correct, and accessible services to providers and vendors who support the claims submission process. The modern services will support CMS’ ability to quickly accommodate policy changes and initiatives that determine claims prices.

“We’ve 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, Bellese Partner and CEO.

“Our goal is to give CMS the flexibility they need to quickly provide accurate pricing and coding services to the Medicare community.” John duClos, Bellese Partner and CTO, added that, “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.”

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