Insurance Underpayments:

A Deliberate Revenue Leak

Big carriers underpay you by design.

We reverse-engineer their playbook and make them pay — claim by claim.

What’s Really Going On

  • Insurance carriers delay, deny, and underpay with surgical precision—that’s not care, it’s commerce.

  • Providers lose 10–20% of eligible revenue over a 12–24-month span, typically buried in contract misalignment.

  • Most Revenue Cycle Management providers chase coding issues. We start with contracts—because that’s the rulebook they’re bending.

Our Underpayment Recovery System

Forensic-level contract audit:

Every claim, every remittance, checked against your exact contract terms.

Proprietary analysis software:

Spots systematic short-pays, compliance errors, and denial patterns carriers don’t want you to see.

Contingency-based pricing:

You pay only if we recover. We win together, or not at all.

Why We’re Different

  • Not just another RCM shop—we’re specialist auditors of what truly hits your bottom line.

  • Recover serious sums: Healthcare organizations frequently reclaim six- and seven-figure revenue gaps.

  • Minimal provider burden—our team handles the heavy lifting with HIPAA-compliant security.

Real Results, Real Talk

“They did an audit we didn’t know was possible and recovered $1.3M we thought was gone forever.”

— CFO, Regional Hospital

Stop letting insurers hold your money hostage.

How It Works

1.

Data Transfer

Securely send us 12–24 months of claims data, contracts, and remittances. We sign BAAs and maintain full HIPAA compliance.

2.

Contractual Alignment Audit

We analyze each claim against your actual contract terms—not the version the payer decided to invent that week.

3.

Remittance Discrepancy Detection

Using proprietary tools and human expertise, we identify payment gaps, improper adjustments, coding manipulation, and systematic denials.

4.

Full Report + Recovery Strategy

You get a line-by-line audit, plus an aggressive recovery game plan. We handle the appeal or direct negotiation if needed.

5.

You Get Paid

We invoice only after revenue is recovered. If there’s no money back, there’s no fee. Period.

Who We Serve

  • Rural and Community Hospitals:

    Thin margins, thick contract confusion—we’re here to protect access to care and stop the financial bleed.

  • Health Systems:

    Multi-location complexity demands a system-wide audit. We’ve got the muscle for it.

  • Physician Groups & Specialty Practices:

    Orthopedics, Cardiology, Oncology—any specialty hit hard by denials and carrier games.

Not sure if you’re a fit?

If you’ve got private contracts with carriers and see more than $10M in annual revenue,

you’re probably owed a chunk of it back.

About Us

We’re not coders. We’re contract enforcers.

Founded by former legal strategists and data analysts, our team exists to call out insurer games and make providers whole. We dig deep into the contract language and remittance behavior to identify and recover what was rightfully yours from day one.

No fluff, no bloated software dashboards. Just recovered revenue and cleaner contracts.

FAQs

We already have a Revenue Cycle Management (RCM) firm. Why use you?

RCM firms handle the full spectrum of billing. We specialize in one thing: identifying and recovering underpayments tied to contractual breaches. We’re the second set of eyes they don’t have time to be.

How much work will this be for my team?

Less than you’d expect. You send the files and sign the BAA. We do the rest.

What kinds of providers benefit most?

Providers with commercial insurance contracts and annual gross revenue over $10M.

How long does the audit take?

4–6 weeks for most standard engagements. Emergency reviews available for critical access hospitals or distressed operators.

Are you HIPAA compliant?

Absolutely. Our data handling, storage, and transmission protocols all meet HIPAA standards.