Underpayment Review
A $3 Underpayment. 200 Claims a Month. $7,200 a Year. One Code.
An underpayment clears as a paid claim and your team moves on, but it quietly drains revenue you earned. Named specialists, backed by technology, compare every payment against your payer contracts and recover what you're owed.
Underpayments Look Like Payments. That's What Makes Them Dangerous.
A short payment posts as paid and never trips an alert, so a quiet, systemic shortfall can run across many codes and payers at once without anyone noticing.
The $5 That Hides in Plain Sight
When a payer sends $187 instead of the $192 you're owed, your system posts it as paid. The difference doesn't trigger a flag, and nobody reviews it, because from every visible angle the claim is resolved.
Small Variances, Multiplied
Now multiply that shortfall across every claim for that code, every day, every month. Most practices have multiple codes across multiple payers where this is happening at the same time.
The Errors You'd Never Catch
These aren't dramatic, easy-to-spot errors. They 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.
Specialists Who Recover Underpayments, Backed by Contract-Level Analysis
Named specialists own the recovery work, and technology handles the part no team can do by hand: we load your payer contracts and fee schedules, then compare every payment against the contracted rate line by line. Not a sample. Not just the high-dollar claims. Every payment, every code, every payer. The engine flags each variance as an exception so our specialists spend their time building the appeal and pressing the payer, not hunting for which checks came in short.
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. A shortfall that turns up while we work your Insurance A/R Follow-Up routes straight here for recovery.
Ongoing Monitoring and Trend Reporting
Underpayment review isn't a one-time audit. We monitor every payment, with monthly reports showing which payers are underpaying, which codes are affected, and whether patterns are improving or worsening.
84%
Collection on AR >90 Days (documented case)
One documented engagement: 375 accounts averaging 224 days old, worked with the same account-by-account scrutiny we bring to short payments.
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.
Documented results; improvements are measured against your own baseline. See how we measure
Underpayment Review FAQs
How do you find underpayments my own team missed?
We load your payer contracts and fee schedules, then technology compares every payment to the contracted rate line by line, every code and every payer, not a sample. When a payment comes in below contract, it surfaces as an exception. Most billing systems post a short payment as "paid" and never flag it, so a $3 or $5 shortfall on a high-volume code can run for months without anyone noticing. Named specialists review each flagged variance and pursue the ones worth recovering.
What happens once an underpayment is identified?
A specialist owns it from there. They appeal the shortfall with the contract documentation that proves what you were owed. When the variance is systematic across many claims, we escalate beyond claim level to the payer representative with aggregate data, so the fix is a system-level correction rather than a one-claim adjustment. The technology surfaces the problem; people do the recovery.
Is this a one-time audit or ongoing?
Ongoing. A one-time audit tells you what you lost last year; it doesn't stop the next quiet shortfall. We monitor every payment and report monthly on which payers are underpaying, which codes are affected, and whether patterns are improving or worsening, so a new variance gets caught while it's still small.
How does underpayment review connect to the rest of the revenue cycle?
It is the catch for money you earned but were paid short of. A claim that comes back short during insurance AR follow-up routes straight here for recovery. Underpayment review also leans on accurate coding: with 99% coding accuracy across 30+ specialties, the contracted rate we compare against is clear, so a variance is a real shortfall rather than a coding question.