Underpayment Recovery
The quietest leak: claims that got paid, just not what your contract says.
Underpayments never trigger an alarm. The claim was 'paid,' the EOB looks routine, and the shortfall hides inside thousands of allowed-amount lines. Industry analyses put the cost at 1–3% of net revenue, every year, compounding silently.
The Problem
The problem: paid ≠ paid correctly.
Nobody reconciles every remit line against contract rates by hand, so systematic shaving goes unnoticed indefinitely. It isn't a denial, so it never even makes the denials queue.
1–3%
Net revenue quietly lost to commercial payer underpayments annually1
What We Do
Deliverables, not promises.
- Contract loading: your payer fee schedules and terms modeled line by line
- Allowed-amount variance detection across every remit, automatically
- Silent-PPO and lesser-of clause detection
- Demand letters at contract rates, with the variance math attached
- Recovery tracking through repricing, project claims, and payer settlement
The Difference
How it's different
Underpayment work is pure data work, which is why it almost never gets done manually. Our pipeline compares every allowed amount against your loaded contract terms (every claim, every payer, every month) and flags variances your team could never catch line by line.
Demands go out with the math attached: contract citation, expected allowable, actual paid, variance. Payers pay documented demands; they ignore vague ones.
What It Costs
Performance pricing or a flat rate. Your choice, your state’s rules.
Model A: a percentage of dollars actually recovered; nothing recovered, nothing owed (most states). Model B: a fixed monthly rate where every recovered dollar is 100% yours (all 50 states). Both start with the free Recovery Audit ($500 value) and its written go/no-go.
See both pricing models →Questions
Asked on every call about underpayment recovery.
We already have a billing company. Wouldn't they catch this?
Billing companies post what the payer pays. Verifying every allowed amount against contract terms is a separate, data-heavy discipline that almost no billing operation staffs.
What do you need from us to start?
Your top payer contracts and fee schedules, plus remit access. The Recovery Audit includes an underpayment spot-check against your top 3 contracts before you commit.
How is this priced?
Same two models as everything we do: a percentage of recovered variance (Model A) or inside the flat-rate program (Model B). See Pricing.
Want underpayment recovery running on your AR?
15 minutes, a real person, no pitch deck. Or skip the call and sign up online. Prefer to dial? (479) 274-0716
Know your number before you sign anything.
The Recovery Audit is a $500 analysis, yours free, in writing, with an honest go/no-go. Limited slots each month.
Sources
- 1.Commercial payer underpayments quietly cost providers 1–3% of net revenue annually. Industry revenue-integrity analyses