Paid isn't the same as paid right.
An underpayment is a claim paid below your contracted rate. It looks like a normal payment, often hidden inside a contractual adjustment, so it rarely appears on a denial report. We compare allowed amounts to your fee schedules and contracts and recover the difference.
Finding money already earned.
Underpayments are invisible until someone compares every payment to the contract.
Load the contracts
Build each payer's fee schedule and payment rules (bilateral, multiple procedure, anesthesia units) into a comparison.
Compare every line
Match allowed amounts on paid claims against expected amounts; flag variances above a threshold.
Recover
Submit reconsiderations or appeals with the contract terms attached; track to payment.
Strategy backed by experienced specialists.
Strategy & Direct Client Partnership led by Rohit Pandey, backed by a dedicated team of credentialed medical coders (AAPC/AHIMA) and seasoned AR follow-up specialists.
What you see each week
- Variance found by payer
- Top underpaid codes
- Recovered amounts
- Payers with repeat patterns
Underpayment recovery: common questions
What is an underpayment in medical billing?
A claim paid below the contracted rate. Common causes: wrong fee schedule year, bilateral or multiple-procedure rules applied incorrectly, anesthesia time recalculated, or a contractual adjustment posted without checking the contract.
Do we need our payer contracts?
Yes. We need contracts or fee schedules to calculate what each claim should have paid.
How far back can underpayments be recovered?
It depends on each contract's reconsideration and audit windows; many limit you to a set number of days or months, so recent claims come first.
10 minutes. One screen. Your numbers.
A short Google Meet with Rohit to look at where your revenue stalls and whether contingency recovery makes sense for your practice. No software change, nothing to pay up front.