Demo data

Payer scorecards

Bring the pattern, not just the claims, to your monthly payer meeting.

Unity Benefit Administrators (TPA)
TPA
Pays under Northlake Health Plan network contract · 60-day window
Claims
15
Underpayment rate
73%
Total variance
$47,020
Avg days to pay
26
Most common root cause
Wrong fee schedule (6 claims)
Crestline TPA Services
TPA
Pays under Meridian Mutual network contract · 45-day window
Claims
11
Underpayment rate
82%
Total variance
$23,653
Avg days to pay
28
Most common root cause
Percent-of-charges error (4 claims)
Northlake Health Plan
Commercial
Section 4.2, Exhibit B · 90-day window
Claims
11
Underpayment rate
36%
Total variance
$5,785
Avg days to pay
33
Most common root cause
Modifier ignored (2 claims)
Federal Medicare
Medicare
Medicare Fee Schedule, Part B · 730-day window
Claims
8
Underpayment rate
63%
Total variance
$3,421
Avg days to pay
26
Most common root cause
Bundling error (2 claims)
Prairie State Medicaid
Medicaid
Provider Agreement §12.3 · 365-day window
Claims
10
Underpayment rate
50%
Total variance
$2,482
Avg days to pay
28
Most common root cause
Missing information (2 claims)
Meridian Mutual
Commercial
Article 6.1, Schedule A · 120-day window
Claims
5
Underpayment rate
40%
Total variance
$2,229
Avg days to pay
33
Most common root cause
Rate underpayment (1 claim)