Contract variance check
Starts whenAn ERA posts
Compares every allowed amount to your fee schedules and flags variances above your tolerance.
Underpayment recovery
Get paid what your contracts say.
Payers short pay more often than anyone has time to check. worklist checks every line, so the money you're owed stops slipping away.
- Every payment checked against your contract
- Short pays disputed with the math
- Recoupments and missing interest caught
How it runs
From short pay to recovered dollars.
- 01
Payment posts
Every paid line is checked against what it should have paid.
- 02
Expected amount computed
Your contract rate times units, with modifier and multiple-procedure rules, place of service and sequestration.
- 03
Variance checked
Anything beyond your tolerance, in dollars or percent, is flagged.
- 04
Posted honestly
Adjusted only down to the expected amount. The rest stays open as underpaid and disputed.
- 05
Grouped and disputed
Short pays grouped by payer and cause, then disputed with the contract clause and the calculation.
- 06
Followed to the money
Followed up, then escalated to the next level until it's paid or closed.
Every automation
What underpayment recovery includes
Each one runs on its own, inside the systems you already use, and only asks a person when your rules say so.
Underpayment dispute
Starts whenA short pay is above tolerance
Sends the dispute with the contract clause and the math, then follows up until it's paid.
Payer pattern grouping
Starts whenShort pays repeat by payer or cause
Groups them so one dispute, or one contract conversation, recovers many claims.
Unexplained partial payments
Starts whenPaid below allowed with no code that explains it
Posts what's right, leaves the gap open, and asks a biller to accept or dispute within five business days.
Recoupment review
Starts whenA PLB takeback, reversal or demand letter arrives
Posts it against the original claim, judges it right or wrong and contests it inside the payer's window.
Missing prompt-pay interest
Starts whenA late payment arrives without interest
Computes the interest due at the prompt-pay rate and asks the payer for it.
Reversals and reprocessing
Starts whenA payer reverses and reprocesses a claim
Nets the new payment against the original, so recovered money and takebacks are clear.
Misdirected payments
Starts whenYour money went to another TIN, or someone else's came to you
Requests reprocessing, or returns the money on time.
Where your team steps in
You decide what to fight. worklist builds the case.
Every short pay is found and prepared. People decide on the disputes and takebacks that matter most.
- Dispute approvalsEach dispute prepared with the clause and the calculation, held for a yes when your rules say Ask first.
- Recoupment decisionsTakebacks above your limit, and every Medicare demand, go to a manager with the deadline to contest.
- Contract conversationsShort pays grouped by payer and cause, ready for your next negotiation.
FAQ
Questions, answered
Where do the expected amounts come from?
Your payer contracts and fee schedules. The calculation covers units, modifiers, multiple-procedure rules, place of service and sequestration.
Will it dispute every penny?
No. You set the tolerance, in dollars or percent, and which disputes need approval.
What about Medicare recoupments?
Every Medicare demand goes to a manager, with the redetermination deadline that stops the recoupment.
Does it handle No Surprises Act disputes?
It prepares them. The decision to go to independent dispute resolution is always yours.
Early access
Run your revenue cycle as workflows.
We are working with a small group of billing and operations teams to shape worklist. Tell us where your work gets stuck, and we'll show you how it would run.
Request early accessor write to [email protected]
One platform, every role