Clearia.

contact@cleariagroup.com

The free diagnostic

Find out what your payers kept.

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, and the number decides everything: whether there's a case, and whether you want us to pursue it.

Request the free diagnostic or write to contact@cleariagroup.com

What the diagnostic is

A contract-versus-payment audit. Your payer contracts specify a rate for every code. Your remittances record what was actually paid. We compare the two, line by line, across a sample period — underpaid codes, downcoded procedures, and 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 — we walk through it together. Your team's part takes about an hour, once.

Free, with no obligation. The diagnostic costs nothing whether or not you engage us afterward. If it finds nothing, you've verified — from your own payment records — that your payers are paying your contracts correctly.

What you receive

From the sample diagnostic sample · synthetic data
$661,000net recoverable identified, annualized — seven-physician orthopedic sample
+40–60%potential profit uplift, net of our fee, at typical practice margins
$0added cost or staff time to capture it — the care was already delivered

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 traced to the payer behavior behind it. You decide what we pursue; nothing is filed without your sign-off.

Figures above are from a synthetic seven-physician orthopedic sample — they show the report's shape, not a projection for your practice.

See a full sample report, traced dollar by dollar →

Process and timeline

  1. Agreement first. A business associate agreement is signed before any data moves. Access is read-only and limited to payment records.
  2. The hour. Your administrator sets up access to remittance reports and shares the payer contracts, with us beside you. After that, we work independently.
  3. The audit. Weeks, not months. We check what each payer paid against the contracted rate, code by code, and trace every shortfall to the pattern behind it.
  4. Findings review. You get the report in dollars and decide what we pursue. If you engage us, recoveries follow each payer's reconsideration timelines — and our fee is a percentage of what's actually recovered. Nothing else, ever.

One constraint is real: payer dispute windows typically run 90 to 180 days, so older claims age out permanently.

Questions practices ask us

What does underpayment recovery cost?

Nothing upfront, ever. The diagnostic is free, and our fee is a percentage of dollars actually recovered. If we recover nothing, you owe nothing.

Is this too good to be true?

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.

How is patient data protected?

Every engagement starts with a signed business associate agreement before any data moves. Access is read-only, limited to payment records, and data travels only through HIPAA-covered channels.

How much of our staff's time does it take?

About an hour, once. Your administrator sets up read-only access to payment reports and shares your payer contracts — we walk through it together. After that we work independently.

Will this create problems with our payers?

No. Underpayment reconsiderations are a routine, contractual process that payers handle every day. We use the dispute mechanisms your contracts already provide, professionally and by the book.

Does this replace our biller or billing company?

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 we only do that job. If anything, work moves off your team's plate: the underpayment appeals and payer follow-up your staff currently handles between everything else become ours to prepare, manage, and see through.

What if you find nothing?

Then you've verified — from your own payment records — that your payers are paying your contracts correctly, and it cost you nothing. That answer has value too.

How long does it take to see results?

The diagnostic takes weeks, not months, 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.

Request the free diagnostic

The diagnostic answers the only question that matters — in dollars, from your own payment records.

Three fields, and we take it from there.

No cost, no obligation. We reply within one business day. Prefer email? contact@cleariagroup.com