Underpayment recovery
Underpayment recovery services that make sure payers pay what they owe
Not every short payment looks like a denial. (Company Name) compares what payers actually pay with your contracted rates, finds underpayments line by line and recovers the difference, so you’re paid what you agreed to.
Payment variance check
CPT 99214
Contract rate
Payer allowed
Below contract
Variance
Identified
Contract terms
Verified
Appeal submitted
With contract proof
Difference recovered
Paid
Example of how an underpaid claim is identified and recovered.
Why underpayments go unnoticed
Underpayments are among the hardest revenue leaks to see, because the claim shows as “paid.” Over months, small differences add up to significant lost revenue.
Paid claims aren't checked
Once a payment posts, few teams compare it to the contract.
Contracts aren't loaded
Without contracted rates in the system, there's nothing to compare against.
Fee schedule updates missed
Payers update rates, and incorrect rates continue for months.
Multiple procedure reductions
Payment reductions applied incorrectly reduce payment on every procedure claim.
Modifier pricing errors
Payers sometimes apply modifiers incorrectly and reduce payment.
Secondary payers short-paying
Secondary payments are rarely checked at all.
Our underpayment recovery service
We load your payer contracts and fee schedules, compare expected and actual payments for every claim line and flag every variance.
Then we appeal underpayments with contract evidence and track recurring patterns by payer, which also helps in future contract negotiations.
- Payer contract and fee schedule review
- Expected reimbursement calculation
- Line-level payment variance analysis
- Multiple procedure and modifier reduction review
- Secondary payment review
- Underpayment appeals with contract evidence
- Payer escalations
- Retrospective underpayment audits
- Overpayment identification for compliance
- Payer-level variance reporting
- Contract renegotiation support data
- Monthly recovery reports
Our underpayment recovery process
A clear method for finding and recovering every short payment.
Step 1
Load contracts
Your payer contracts and fee schedules are reviewed and loaded.
Step 2
Compare payments
Every paid line is compared with the expected amount.
Step 3
Confirm variances
Short payments are verified against contract terms.
Step 4
Appeal and recover
Underpayments are appealed with supporting evidence.
Step 5
Report patterns
Recurring issues are reported by payer for future negotiations.
What your practice gains
Underpayment recovery protects the rates you negotiated.
Recovered revenue
Collect the difference payers owe you.
Contracts enforced
Make sure payers honor agreed rates.
Payer insights
See which payers underpay most often.
Stronger negotiations
Use real data in contract discussions.
Compliance checks
Overpayments identified and handled correctly.
Higher net collections
More revenue from the same work.
Why practices choose (Company Name) for underpayment recovery
Finding underpayments takes contract knowledge and line-by-line analysis. Recovering them takes persistence. We provide both.
- Line-level payment analysis
- Specialists who understand payer contracts
- Appeals backed by contract evidence
- Payer-level variance reporting
- Flexible pricing, including contingency options
- HIPAA-focused processes and a signed BAA
Underpayment causes we review
We check every common cause of short payments.
Wrong fee schedule
Outdated rates
Multiple procedure reductions
Modifier reductions
Bundling errors
Incorrect units
Secondary short pays
Place of service rates
Related medical billing services
Underpayment recovery connects to these services across your revenue cycle.
Payment posting
Payments posted and reconciled accurately.
Fee schedule analysis
Fees and contracts compared to find missed revenue.
Denial management
Denials analyzed, corrected and appealed.
A/R follow-up
Persistent payer follow-up until every claim is resolved.
Underpayment recovery FAQs
Common questions about recovering insurance underpayments.
What is an insurance underpayment?
An underpayment happens when a payer pays less than the amount agreed in its contract with the provider, or less than its published fee schedule, for a covered service.
How common are underpayments?
Underpayments are a common revenue leak for practices of all sizes, especially when contracts and fee schedules aren’t checked against actual payments.
How do you find underpayments?
We compare the expected payment from your contracts or fee schedules with the actual payment on each claim line and investigate any difference.
Do I need to provide my payer contracts?
Yes, contracts or fee schedules make analysis most accurate. If you don’t have them, we can help you request them from payers.
Can you review past payments?
Yes. We can run a retrospective review of paid claims within payer appeal timelines to recover past underpayments.
How is underpayment recovery priced?
It’s often priced as a percentage of the amount recovered, so you only pay when we recover money for you.
Make sure you're paid what your contracts promise
Get a free review of your payments against your contracts. We’ll show you where you’re being underpaid.