Underpayments
Find the codes you’re paid under your own contract.
Upload your allowed amounts by code. We compare each to the rate the payer published for you and show you the gap.
- 01
Export totals, not claims
From your practice management system, export allowed amounts grouped by CPT code, modifier and place of service, with a claim count — one row per combination, not one row per patient. A whole practice’s code mix fits in a few dozen rows. We give you a sample file to match.
- 02
We compare allowed to published — never paid
Each code’s allowed amount is checked against the rate the payer published for your NPI. We deliberately use the allowed amount: “paid” is net of the patient’s deductible and copay, and comparing to it produces false alarms across most of the commercial market.
- 03
You get the gap, by code
Which codes were allowed below the published rate, how many claims that touched, and the dollar difference — code by code, sorted worst first. Codes we can’t price (a percentage-of-charges contract, or a payer that doesn’t list you) say so plainly instead of pretending.
What we won’t tell you
A gap, not a promise.
We show the observed difference between what was allowed and what was published. We do not print a single “you are owed $X” figure or an average — whether a gap is recoverable depends on the contract terms, the claim, and the appeal, and we would rather hand you the evidence than a headline.
Never leaves your computer
- Patient names, member IDs, dates of birth
- Claim numbers or any free-text field
- Individual claims — only aggregates are sent
What we receive
- CPT code, modifier, place of service
- Allowed amount and claim count, per combination
- Nothing that identifies a person
Check one payer this week.
Included on every paid plan. Start with your biggest payer and your ten most-billed codes.