Underpayment Review
A $3 Underpayment. 200 Claims a Month. $7,200 a Year. One Code.
Underpayments don't announce themselves. A claim gets paid, the check clears, and your team moves on. But was the payment correct? KeyMed reviews every payment against your contracted rates to identify the shortfalls that most billing teams never catch — because they look like payments, not problems.
Underpayments Look Like Payments. That's What Makes Them Dangerous.
When a payer sends a check for $187 instead of the $192 you're owed, your system posts it as paid. The $5 difference doesn't trigger an alert, doesn't generate a flag, and nobody reviews it — because from every visible angle, the claim is resolved. Now multiply that across every claim for that code, every day, every month. Most practices have multiple codes across multiple payers where this is happening simultaneously. These aren't dramatic, easy-to-spot errors. They're quiet, systemic shortfalls that look like correct payments because the adjustment code is right and the check cleared. You wouldn't know if a payer stopped paying the right amount. You'd just keep posting it.
Contract-Level Payment Analysis
We load your payer contracts and fee schedules, then compare every payment against the contracted rate line by line. Not a sample. Not the high-dollar claims. Every payment, every code, every payer.
Volume-Weighted Variance Detection
We identify underpayments and weight them by claim volume, so the variances that cost the most money get prioritized first. A $3 shortfall on a high-volume code matters more than a $30 shortfall on a code you bill twice a month.
Appeal and Payer Escalation
Once identified, underpayments are appealed with contract documentation. When the problem is systematic, we escalate beyond claims level to the payer representative with aggregate data that demands a system-level correction — not just claim-by-claim fixes.
Ongoing Monitoring and Trend Reporting
Underpayment review isn't a one-time audit. We monitor every payment on an ongoing basis, with monthly reports showing which payers are underpaying, which codes are affected, and whether patterns are improving or worsening.
84%
Aged AR Collection Rate
Including revenue recovered from claims that were marked as paid but weren't paid correctly.
99%
Coding Accuracy
Clean coding means clear contracted rates to compare against.
25+
Years of Payer Contract Experience
Our team knows where payers cut corners because we've been watching them do it for decades.