# RateBench — Underpayment check

> Upload allowed-amount totals by CPT code; RateBench compares each to the rate your payer published for your practice and shows the codes allowed below it, the claims affected and the dollar gap. Totals only — no patient data leaves your computer.

- Human page: https://ratebench.health/features/underpayments
- Product (sign up / app): https://app.ratebench.health
- This document: https://ratebench.health/underpayments.md

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## What it is

A check of whether each payer allowed the rate it published for your practice. It
finds potential underpayments: claims that closed at a zero balance with the
shortfall posted as a contractual adjustment.

## How it works

1. Build your fee schedule: your NPI, the codes you bill and the payers you take.
   It holds the rate each payer published for you under Transparency in Coverage.
2. Export allowed amounts grouped by CPT code, modifier and place of service, with
   a claim count — one row per combination, never one row per patient. File: CSV
   with columns `cpt_code, modifier, place_of_service, allowed_amount, claim_count`.
3. Upload it for one payer. Each code's allowed amount is compared with the rate on
   your fee schedule (a code not on the schedule is looked up on its own). It uses
   the **allowed** amount deliberately: "paid" is net of the patient's deductible
   and copay, and comparing to it produces false alarms. Within $1 of the rate
   counts as the rate.
4. Claims carrying a modifier that changes payment (26, TC, 50, 51, 52, 53, 54, 55,
   62, 66, 73, 74, 78, 80, 81, 82, AS) are set aside and listed as not compared,
   never reported as underpaid. Modifiers 25, 59 and others that don't change
   payment are compared.
5. You get, code by code (worst first): which codes were allowed below the
   published rate, how many claims that touched, and the dollar difference. Codes
   it can't compare (percentage-of-charges pricing, facility-only rates, or not in
   the payer's file) say why. Each check is saved and downloads as CSV.

## What it will not do

It shows the observed gap, not a single "you are owed $X" headline. A contract
amendment after the file was published, bundling edits or a secondary payer can
explain a real difference; whether a gap is recoverable depends on the contract,
the claims and the payer's process.

## Privacy

Patient names, member IDs, dates of birth, claim numbers and free-text never leave
your computer; only CPT code, modifier, place of service, allowed amount and claim
count (aggregated) are sent. No patient data reaches RateBench.

## Price

On every paid plan. Practice: $99/month, with the fee schedule and
rate monitoring; cancel anytime. Sign up: https://app.ratebench.health/sign-up