Wakely Medicare Repricing Analysis Tool (WMRAT)
See how your payment & pricing practices measure up with WMRAT.
Comparing medical claim allowed amounts to Medicare FFS rates across the industry provides a useful benchmark for payers to better understand their data and payment practices, and for providers to analyze how they are being reimbursed.
Using the Wakely Medicare Repricing Analysis Tool (WMRAT), Wakely provides our clients with claim line level detail and summaries of medical claims repriced to Medicare FFS rates, offering a common language for comparing payment rates across multiple lines of business, categories of service, geographic locations, and providers. These comparisons can reveal areas of opportunity to improve pricing and payment systems.
You provide the data. We report the insights.
Using the WMRAT tool, Wakely can reprice your own claims data and/or national datasets, such as our own Wakely ACA database or MerativeTM MarketScan® data. This allows for both regional and national level benchmarking to see how your payment practices compare.
Insights from WMRAT reports can be invaluable for organizations seeking to:
- Create pricing assumptions
- Negotiate more competitive provider contacts
- Validate internal payment procedures
- Set up new capitation arrangements
- Discover types of services with unfavorable payment rates
- Identify discrepancies between contracted rates and actual payment rates
Request a consultation to learn more about WMRAT.
From line level detail to the big picture, get it all from WMRAT.
In addition to repriced claim line level detail data, the WMRAT reporting package includes several useful summaries to help you understand key information at a quick glance:
- By year and incurred month
- By in-network and out-of-network
- By provider
- By provider CBSA
- By member CBSA
- By inpatient major diagnostic category
- By outpatient category of service
- By outpatient status indicator
- By professional fee schedule type
- By outpatient category of service
- By outpatient status indicator
- By professional fee schedule type
- By professional bodily system
Custom summaries are available on request.
Medicare payment systems WMRAT supports:
- Inpatient Prospective Payment System (IPPS)
- Outpatient Prospective Payment System (OPPS)
- Physician
- Durable Medical Equipment (DME)
- Parenteral and Enteral Nutrition (PEN)
- Part B RX
- Clinical Lab
- Ambulance
- Anesthesia
- Inpatient Psychiatric Facility Prospective Payment System (IPF PPS)
- Ambulatory Surgical Center Payment System (ASC)
- Federally Qualified Health Centers Prospective Payment System (FQHC PPS)
Wakely is continuing to add more systems; contact us for the most up-to-date list.
