Insurance Underpayment Recovery

We measure your paid and denied claims against your payer contracts, find where you were reimbursed less than you were owed, and pursue the difference, including dormant claims your team already worked, closed, and written off.

Payers rarely reimburse a provider exactly what the contract entitles them to. Claims are short-paid by small amounts, denials age out faster than a billing team can appeal them, and underpayments that look minor on any single claim get written off rather than fought one by one. Spread across thousands of claims and a full year of volume, that gap stops being a rounding error and becomes one of the largest sources of lost revenue a healthcare organization has. It sits unnoticed for a simple reason: no one has the time or the specialized tooling to audit every payment against every contract.

Our approach is consultative and led by your own data. We examine your operational and financial information, measure what you were actually paid against what your payer contracts require, and surface every place the two do not match. From there, specialists who do this work every day pursue recovery on your behalf. That includes dormant claims, the ones your team already worked, closed, and stopped chasing, and claims a previous recovery vendor has already been through. The engagement begins with a Business Associate Agreement, and your data moves through a secure portal rather than email. The lift on your side is a one-time data pull of a few hours to begin, then roughly fifteen minutes a week. Because the process runs alongside your existing operations and works with the EMR and provider systems you already use, it brings in recovered revenue without adding to your billing team's day.

The result is revenue you already earned finally reaching your account, which lifts more than your top and bottom line. Because the work is contingency based, there is no cost to your organization to find out what is there, and recovery is paid only out of what is actually recovered. It improves budgets immediately and strengthens the credit ratings and valuations that depend on them. This work spans the full range of healthcare, from large hospital systems with hundreds of locations, to small practices where every dollar decides whether the doors stay open, to independent labs competing on thin margins. The common thread, proven across more than 85 hospital brands and the movement of tens of billions of dollars in healthcare payments, is that providers are almost always owed more than they collect, and that money is recoverable.

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