Payment Reconciliation — Catch Every Underpayment
Payers underpay constantly. Automated detection catches underpayment, recovering $45K+ annually with 85% appeal win rate.
Proven Results
- $45K Average Annual Recovery
- 98% Payment Accuracy
- 100% Claims Reviewed
- 85% Successful Appeals
Common Challenges
Payment Variances Go Undetected
Practices lack time and expertise to compare actual payments against contracted rates, allowing underpayments to go unnoticed.
Contractual Adjustment Verification
Staff cannot validate whether payer-applied contractual adjustments match contracted fee schedules and discount percentages.
Time-Consuming Manual Reconciliation
Manually comparing EOBs to expected payments for hundreds of claims monthly is impossible with limited staff resources.
Audit Preparation Challenges
Practices struggle to prepare for payer audits and lack documentation proving they were paid correctly.
Our Solutions
Automated Variance Detection
Advanced software compares actual payments to contracted fee schedules and automatically identifies underpayments and incorrect adjustments.
- Automated payment vs contract comparison
- Real-time underpayment identification
- Exception-based review process
- Flags variances exceeding thresholds
Contract Verification Services
Expert team reviews payer contracts, loads fee schedules into system, and validates that payments match contracted rates.
- Complete contract analysis
- Fee schedule validation and loading
- Contractual adjustment verification
- Multi-payer contract management
Underpayment Recovery
Systematic process to appeal underpayments and recover money owed under payer contracts.
- Underpayment appeal preparation
- Documentation and submission
- Follow-up until resolution
- Recovery tracking and reporting
Audit Support & Documentation
Comprehensive records and reports supporting audit defense and providing proof of correct payment.
- Audit-ready documentation
- Payment history reports
- Variance analysis summaries
- Contract compliance evidence
Service Features
Payment vs Contract Analysis
Systematic review comparing actual EOB payments against contracted fee schedules to identify discrepancies.
- EOB data extraction
- Contract rate comparison
- Variance calculation
- Exception reporting
Underpayment Identification
Automated detection of payments below contracted rates requiring appeal and recovery action.
- Real-time variance detection
- Threshold-based alerts
- Prioritized recovery list
- Financial impact calculation
Recovery & Appeals
Complete appeals process for underpayments including documentation, submission, and follow-up.
- Appeal letter generation
- Supporting documentation
- Submission and tracking
- Payment recovery confirmation
Reconciliation Reporting
Detailed reports showing payment variances, recovery efforts, and financial impact by payer.
- Variance summary reports
- Payer performance analysis
- Recovery tracking
- Audit trail documentation
Related Billing Resources
Key Services
- payment reconciliation
- EOB reconciliation
- remittance processing
- underpayment recovery
- contractual adjustment verification
- payment variance detection
- payer underpayment appeal
- fee schedule analysis
- payment accuracy
- medical billing reconciliation
Contact Medtransic today for expert payment reconciliation services. Call 888-777-0860 or visit https://medtransic.com/contact for a free consultation.