Underpayment

When a payer reimburses less than the contracted allowed amount or fee schedule. Often masked by complete-claim-payment status on the 835 even though the math is wrong. Detection requires comparing 835 paid amounts to the contracted fee schedule. Industry estimates put underpayment loss at 1 to 3 percent of net revenue for practices that do not actively audit. Recovery requires payer-specific underpayment dispute processes.