Underpayment recovery for independent specialty practices
Insurers quietly keep part of what your practice already earned — a downcoded procedure here, an underpaid code there, every claim closed at a zero balance, looking paid. Clearia finds it in your paid claims, shows it to you in dollars, and gets it back. No upfront fee, no software, no change to how you bill. We're paid only from what we actually recover.
That average includes hospital systems with entire teams watching for it. Independent practices, where nobody watches, sit at the exposed end of the range.
We've seen what checking turns up: one $20M independent practice ran the audit on its own data — with us in the room — and found 6 percent.
And it's pure margin. Recovered underpayment has no cost attached — no staff time, no supplies, no overhead; the care was already delivered. At typical practice margins, the conservative end of the range equals a tenth of your profit. At six percent, it can be a third.
Each underpaid claim closes at zero balance, so no alert fires. And payer dispute windows run out in 90 to 180 days — what stays unnoticed long enough becomes unrecoverable, permanently.
This is not a gap in your team's work. A biller's job is keeping claims moving — and payer-side shortfalls are built to look like finished business. Catching them means checking every remittance line against the contracted rate for that code, payer by payer, on claims that show a zero balance.
No practice of 3 to 15 physicians staffs that job. And chasing a single $180 shortfall never pays for the hour it takes — it only becomes worth doing when someone finds the four hundred claims that follow the same pattern and pursues them as one case. That is the job we built Clearia to do.
Here's what makes recovery possible: underpayment isn't random — it's systematic. Payers run on rules, and the same quiet rule fires the same way across thousands of claims. Each payer has signature behaviors. We study them for a living:
We don't just compare payments to contracts. We recognize the pattern behind each shortfall — and know which ones payers reverse when challenged correctly. Money written off as paid isn't lost; it's unresearched. Payers count on no one doing the research — and when someone does, their own reconsideration process becomes the instrument that pays it back. We use their rules, their process, and their paper trail — better than they expect anyone to.
You've spent an hour and paid nothing — and you'll know, from your own payment records, that your payers are paying your contracts correctly. That answer is worth having.
You pay only out of dollars that actually arrive. No retainer, no hourly fees, no invoice to gamble on.
We carry the risk of being wrong — which is exactly why we won't take an engagement unless the diagnostic shows real recoverable dollars. Our incentives and yours point the same direction: worst case, you get a free expert read of your payment data.
Find out which side of that bet your data lands on.
Request the free diagnosticWe do one job: find what payers underpaid, and get it back.
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Find out what your payers kept — in dollars, from your own payment records.
The diagnostic is free, takes about an hour of your team's time, and carries no obligation afterward.