Findings
Every dollar that was due, and where it went.
Built from your own files, not estimates. Contract rate, payer decision, bank deposit — three numbers per claim, and a reason for every difference. This is what a first audit comes back with, and the first one is free.
Owed per contract
$1,431,208
412 claimsflagged in this run
Allowed by payers
$1,284,900
−10.2%vs. contract
Cash received
$1,253,120
−$31,780no deposit found
Identified
$146,308
ACTIONABLEunderpaid + unpaid + AR
Downcoded claims
118 claims · $41,900
Swipe sideways for every column →
PATIENT / CLAIMYOU BILLEDTHEY PAIDCONTRACTPAIDSHORT
Nadia PetrovCLM-89114 · UHC9921499213$142.00$118.40−$23.60
Owen BradyCLM-89158 · Aetna9921599214$198.00$142.00−$56.00
Camille RiosCLM-89203 · BCBS9920499203$186.50$131.20−$55.30
Darius ColeCLM-89402 · Aetna9920599204$246.00$186.50−$59.50
The level you billed against the level the payer actually paidNet variance −$146,308.42
Patient balances by age
Assigned by the EOB, no payment received
Claims with no payment at all
Billed, but nothing ever landed
Payment issued, never deposited
The EOB says paid; no matching check or transfer
$18,940
41 claims
Billed, no EOB anywhere
No payer decision in any folder for the claim
$7,620
22 claims
Denied, never appealed
Denial reason on file, appeal window still open
$4,180
14 claims
Payer scorecard
WORTH CHASING THIS WEEK
Appeals expiring in 7 days$12,460
Missing deposits over 21 days$9,840
Underpaid, same CPT pattern$8,120
Re-ranked every run by dollars, deadline and likelihood of recovery.
Bring one folder. The first audit is free, and it comes back in a day.
Your own files, in a private sandbox under a signed BAA. You see what you were owed before you have paid us anything.