Payer Contract Underpayment & Variance Analyzer
Practices lose 4%–7% of earned clinical revenue to silent PPO fee reductions and algorithmic underpayments. Uncover your contractual variance, model state prompt-payment statutory interest, and generate formal dispute demands.
Payer Contract Underpayment & Variance Analyzer
Uncover silent payer underpayments where claims are paid below contracted fee schedule rates. Calculate annual revenue leakage, prompt-pay statutory interest penalties, and generate formal dispute letters.
Fee Schedule & Adjudication Parameters
Enter your contracted allowable vs the actual amount remitted on your 835 ERA remittance.
DEMAND FOR CONTRACTUAL UNDERPAYMENT ADJUSTMENT & STATUTORY INTEREST Date: 9/8/2026 To: Payer Network Contracting & Claims Recovery Division (UnitedHealthcare) Re: Ongoing Systematic Underpayment on CPT Code 93306 (Complete Echocardiogram with Doppler) Dear Claims Administrator, Please accept this formal demand for immediate audit and contract variance reconciliation on claims submitted for CPT 93306. CONTRACT VARIANCE SPECIFICATIONS: - Contracted PPO Fee Schedule Allowable: $248.00 - Actual Remitted / Paid Allowable: $194.50 - Discrepancy / Net Underpayment per Claim: $53.50 - Estimated Cumulative 12-Month Underpayment Volume: $54,570 STATUTORY CITATION: Pursuant to Florida Statute § 627.6131 (12% per annum simple interest), clean claims paid below contracted rates or adjudicated beyond 45 days incur mandatory statutory interest. Total accrued statutory interest penalty: $6,548. Please reprocess all underpaid claims at the contracted rate and remit outstanding balances within 30 days.
Request Full Contract Underpayment Audit
Aethera cross-references 100% of your 835 remittance data against your active commercial fee schedule contracts to reclaim underpaid balances.
Turn these Contract Underpayment Analyzer insights into recovered cash
Payer underpayments rarely get resolved by automated clearinghouses because claims aren't rejected—they're just quietly underpaid. Aethera cross-audits 100% of remittances against contracted fee schedules. Let our senior AAPC-certified billing team audit 50 of your active claims or past denials — completely free, with guaranteed under-48-hour findings.
Test our scrub rules and appeal workflow on 50 real claims. Zero commitment, no credit card required.
Upload your aging report for instant benchmark comparisons against MGMA standards and recoverable cash projections.