The problem
When a payer pays less than your contract requires, the shortfall is usually written off as a contractual adjustment. The claim shows a zero balance and no one looks at it again.
The causes are routine: fee schedules loaded late in January, multiple-procedure reductions applied to the wrong line, implant and drug carve-outs missed, and new procedure codes that were never added to a contract.
How we work
- A free audit. Under a signed business associate agreement, we analyze twelve months of your remittance files against your top payer contracts and give you a written finding: dollars identified, by payer and by root cause.
- Recovery. If the finding is worth pursuing, we work the appeals and are paid a share of what is actually recovered.
- Monitoring. Ongoing, we check payments as they arrive, so problems surface while they are still inside appeal windows.
See a sample audit, built on synthetic data →
How we handle your data
- We sign a business associate agreement before receiving any data.
- We follow the HIPAA Security Rule: encrypted storage and transfer, multi-factor authentication, access logging, and a documented risk analysis.
- All work is done in the United States. No offshore access.
- We request the minimum necessary data, and delete it within 30 days of delivering your report.
Contact
Please don't send patient information by email. We'll set up secure transfer once a business associate agreement is in place.