Underpayment Analysis

Underpayments refer to payments made by the insurance companies that are less than the agreed upon rates. These can often go unnoticed and can make a significant dent to your healthcare organization’s bottom line. These are often disguised in the garb of contractual adjustments.

ExpressRCM deploys data analytics to review and analyze each payment with the contracted amounts based on each payers’ agreed upon rates, identifies underpayments, and files appeals to get the balance payment done. We especially focus on trends of similar underpayments, which when resolved get you more bang for the buck!

Our approach includes:

  • Reviewing insurance payment data to assess all payments
  • Comparing payment amounts to the managed care contracts
  • Working with each payer to validate the findings and decide the best course of action to get balance payment
  • Analyzing trends and resolving broader issues with payers for mass resolution of underpayment cases
  • Performing root cause analysis and suggesting corrective action for future