Free template
Underpayment audit template for medical practices.
An Excel workbook that holds your allowed amounts against your contracted rates, code by code, and totals the codes a payer allowed below them. Totals only, no patient data.
Get the underpayment audit template
An Excel file. Enter your email and it downloads straight away; we’ll email you a copy too.
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What’s inside
Four tabs, the same rules as our underpayment check.
The steps, and a worked example with made-up figures.
One row per CPT code, modifier and place of service: the allowed amount per claim and a claim count, from your practice management system. The same columns RateBench reads, so this tab saved as a CSV uploads straight in.
Your rows appear automatically. Type your contracted rate for each code and it works out the gap per claim and in total. Within $1 of the rate counts as the rate; rows with a modifier that changes payment are set aside.
Codes compared, codes allowed below your rate, the claims affected, the total gap, the claims set aside, and the rows still waiting for a rate.
Using it well
Allowed amounts, one payer, a quarter at a time.
Use the allowed amount, not the paid amount. The paid amount is net of the patient’s deductible, coinsurance and copay, so comparing it to your rate flags claims that were paid exactly right. Allowed vs paid vs contracted, explained → The check, step by step →
Start with your biggest payer and a quarter of claims. A gap that shows up on every claim for a code is a pattern, which is easier to raise with the payer and worth more than a one-off.
A gap is worth checking, not a guaranteed recovery: a contract amendment, bundling edits or a secondary payer can explain a real difference. What’s left is usually raised as a reprocessing request or appeal, citing your contract and the claims.
Skip the hand work
Don’t have your rates to hand?
The slow part of this template is typing in a contracted rate for every code. RateBench reads the rate each payer published for your practice, builds your fee schedule, and runs the same comparison on your uploaded totals. On every paid plan, from $99 a month.
Questions
The template, answered.
Is the template free?
Yes. Enter your email and it downloads straight away; we email you a copy too. RateBench itself, which does the comparison for you from the rates your payers publish, is a paid plan from $99 a month.
Does it need patient data?
No. You enter totals: one row per CPT code, modifier and place of service, with the allowed amount per claim and a claim count. No names, dates of birth, member IDs or claim numbers.
Where do I get my contracted rates?
From your contract’s rate exhibit, or from the rate each payer publishes for your practice under the federal Transparency in Coverage rule. RateBench reads those published rates and lays them out by CPT code.
Why does it set some rows aside?
A claim with a modifier that changes what the payer pays (26, TC, 50, 51, 52, 53, 54, 55, 62, 66, 73, 74, 78, 80, 81, 82 and AS) is allowed below the base rate by design, so the template doesn’t count it as underpaid. Modifiers such as 25 and 59 don’t change payment and are compared as normal.
Can I use it with RateBench?
Yes. Its “Your totals” tab has exactly the columns RateBench’s underpayment check reads. Save that tab as a CSV and upload it, and RateBench holds each code against the rate your payer published for you.