Recovering An Average Of 22% Underpaid Claims — 100% Of The Time
Our proprietary forensic audit software identifies and recovers underpayments on "zero-balance" and previously adjudicated claims that traditional RCM software misses. 100% contingency-based—you pay nothing unless we recover money for you.
22% average recovery on "paid" claims that are actually underpaid. Money left on the table from BCBS, Aetna, United, Humana, and more.
Our audit begins after day 91—once your internal processes are complete. We capture what traditional systems miss going back 1-3 years.
Average Underpayment
Recovery Rate
Recovery Range
Across Facilities
Healthcare Facilities
Served Nationwide
Claims Lookback
Period
Contingency-Based
Zero Upfront Cost
Your "paid" claims may be significantly underpaid—and traditional RCM systems aren't catching it.
Most healthcare facilities rely on revenue cycle management software like Epic, PMMC, or Cloudmed to identify underpayments. But these systems only scratch the surface.
Typical RCM underpayment recovery rate
That's money left on the table—every month, every year, adding up to millions in lost revenue.
Our proprietary software is not an ancillary service—it's a complete forensic audit designed to capture underpayments that traditional systems miss, starting AFTER your RCM process is complete.
Our average underpayment recovery rate
We recover 10%-35% of underpaid claims with 22% being the national average—100% of the time.
Our underpayment recovery program works across all healthcare facility types. If you have insurance contracts and adjudicated claims, we can recover your underpayments.
Community hospitals, regional medical centers, specialty hospitals, and health systems of all sizes.
Ambulatory surgery centers, outpatient surgical facilities, and specialty procedure centers.
Walk-in clinics, urgent care facilities, and immediate care centers.
Imaging centers, clinical laboratories, and diagnostic testing facilities.
Large physician practices, multi-specialty groups, and professional associations.
Inpatient rehab facilities, outpatient therapy centers, and specialty recovery programs.
A risk-free, performance-based approach to recover revenue lost to complex underpayments and close revenue gaps.
Proprietary software developed by former DOJ healthcare fraud analysts who identified systematic payer underpayment patterns
Underpayment Recovery
For Zero-Balance Adjudicated Claims — All Payers
Our program begins only after your facility's revenue cycle team has fully adjudicated a claim and exhausted all internal procedures—typically at least 90 days after claim submission. We then audit claims going back 1-3 years (depending on payer contracts), capturing significant underpayments that would otherwise go uncollected.
Recovery Rate Range
National Average
Claims Lookback
Our process is designed to be completely non-disruptive to your existing operations. We handle the heavy lifting.
Contracts finalized and signed. Cancelable until software implementation.
Securely upload remittances to our HIPAA-compliant platform.
Provide payer contracts and addendums for analysis.
Our specialists customize software to identify underpayments.
Compare paid vs. underpaid claims and find patterns.
Consult with your billing team for 100% accuracy.
We handle all disputes, filings, and settlements.
Recovered payments remitted directly to your facility.
Our software has helped over 500 healthcare facilities recover underpaid claims. Here are a few success stories.
Case Study — Texas
Recovered from BCBS alone
Specializing in emergency care, general surgery, & basic inpatient services. Faced challenges with high claim volume (10,000+ monthly) and limited audit resources.
Case Study — Louisiana
Recovered from top 4 payers
Specializing in opioid dependence and post-stroke/cardiac recovery. Struggled with complex billing policies and limited staff.
Case Study — Pennsylvania
Recovered from 4th largest payer alone
Specializing in orthopedic & sports medicine—surgeries, PT, rehab, pain management. Representing 18% of collections from that single payer.
Actual facility names and referrals can be provided once an agreement is signed. Agreements can be cancelled up to time of software implementation.
Our process begins after your RCM software has completed its work. We capture 10%-35% of underpaid claims, compared to RCM software's 2%-5%.
None. We work on a 100% contingency basis and only earn after you recover funds. There are no fees or out-of-pocket costs.
No. We integrate seamlessly and require no workflow changes. Our process is completely non-disruptive to your operations.
Our audit typically takes 6-9 months, depending on claim volume and payer responsiveness.
We can audit claims going back 1-3 years based on payer contracts, significantly increasing potential recoveries.
Payments are remitted directly to your facility by the insurance payers. We are compensated only after you receive funds.
Your "paid" claims may be underpaid by 10-35%. Let us find the money that traditional RCM systems miss—with zero risk to your facility.
22% Avg Recovery
Zero-Balance Audit
All Payers
BCBS, Aetna, United & More
HIPAA Compliant
Secure Platform
Non-Disruptive
No Workflow Changes