Cross-verify all payments with EOBs and reports to ensure every claim is paid correctly and detect underpayments.
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
Client Testimonial
Payment reconciliation identified $58K in underpayments from our largest payer over 18 months. We had no idea
we were being underpaid until Medtransic's automated variance detection flagged the issues. They recovered
$52K through appeals. This service pays for itself many times over.