The free diagnostic
A free, line-item audit of what each payer paid against your contracted rates, built from records you already have. It ends in a number. That number decides everything: whether there's a case, and whether you want us to go after it.
A contract-versus-payment audit. Your payer contracts set a rate for every code. Your remittances record what actually got paid. We compare the two, line by line, across a sample period, and pull out the underpaid codes, the downcoded procedures, and the bundled or denied line items your fee schedule says are payable.
Built from records you already have. A business associate agreement is signed before any data moves. Then your administrator sets up read-only access to payment reports and shares your payer contracts, and we walk through it with you. Your team's part takes about an hour, once.
Free, with no obligation. The diagnostic costs nothing, whether or not you engage us afterward. And if it finds nothing? Then you've confirmed, from your own payment records, that your payers are paying your contracts correctly. Worth knowing.
Your report is a line-item accounting: which payer, which codes, which claims, how much, and what's still inside the dispute window. Each finding gets traced to the payer behavior behind it. You decide what we pursue, by pattern and by insurer, once. After that, we file as your authorized representative.
The figures above come from a synthetic seven-physician orthopedic sample. They show the shape of the report, not a projection for your practice.
One constraint is real. Payer dispute windows typically run 90 to 180 days, so older claims age out permanently.
Nothing upfront, ever. The diagnostic is free. Our fee is a percentage of dollars actually recovered, so if we recover nothing, you owe nothing. How to compare recovery services.
No. It's arithmetic. Your payer contracts specify a rate for every code. Your remittances record what was actually paid. We compare the two, line by line. And because underpayment follows payer-specific patterns, one confirmed shortfall usually points to hundreds more like it. We pursue them through each payer's own reconsideration process. The money exists because, in most practices, nobody has ever looked.
Every engagement starts with a signed business associate agreement, before any data moves. Access is read-only and limited to payment records. Data travels only through HIPAA-covered channels.
About an hour, once. Your administrator sets up read-only access to payment reports and shares your payer contracts, and we walk through it together. After that we work on our own.
No. Underpayment reconsiderations are routine. Payers handle them every day, and the process is written into your contracts. We use the dispute mechanisms those contracts already provide, professionally and by the book. What Florida's prompt-pay law says payers owe you.
No. We never touch claim submission, posting, or your billing workflow. Underpayment sits on the payer's side of the ledger. Finding it is a different job from billing, and that job is the only one we do. If anything, work comes off your team's plate: the underpayment appeals and payer follow-up your staff currently squeezes in between everything else become ours to prepare, manage, and see through. Why a short payment looks finished to a billing team.
Then you've verified, from your own payment records, that your payers are paying your contracts correctly. It cost you nothing. That answer has value too.
Weeks, not months, for the diagnostic itself, once we have access to your remittances and contracts. Recoveries then follow each payer's reconsideration timelines. One constraint is real: payer dispute windows typically run 90 to 180 days, so older claims age out permanently. Appeal deadlines by payer.
The diagnostic answers the only question that matters, in dollars, from your own payment records.
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