Good morning.
Here's what PayerFight found in your revenue cycle.
Potential Revenue IdentifiedAI-powered analysis
$47,382
Across 4,862 analyzed insurance claims
$21,640Potential Underpayments
$13,820Appealable Denials
$7,412Contract Variances
$4,510Other Revenue Leakage
Revenue Recovered
$18,740
Real progress. Revenue returned.
Recovery progress39.5%
39.5% of identified opportunities recovered
Revenue Opportunity Trend
A clearer picture of your revenue, month by month
Potential revenue identified+22% this quarter
Where Your Money Is Getting Stuck
Potential opportunities by payer
| Payer | Claims | Underpaid | Denials | Opportunity |
|---|---|---|---|---|
| UUnitedHealthcare | 1,284 | $8,420 | $4,860 | $14,280 |
| aAetna | 1,106 | $4,820 | $4,212 | $10,840 |
| CCigna | 946 | $2,900 | $1,900 | $8,721 |
| HHorizon BCBS | 982 | $3,400 | $1,600 | $7,406 |
| oOscar | 344 | $1,200 | $800 | $3,212 |
| +Other | 200 | $900 | $448 | $2,923 |
Priority Opportunities
High-impact findings worth a closer look
UHigh confidence
UnitedHealthcare 90837 reimbursement discrepancy
90837 claims appear to have been reimbursed below the contracted rate.
$6,804potential recovery · 42 claims
Review OpportunityaHigh confidence
Aetna denial pattern detected
PayerFight identified a recurring denial pattern that may be appealable.
$4,212potential recovery · 18 claims
Review OpportunityCMedium confidence
Cigna payment variance
Allowed amounts differ from the reimbursement terms currently on file.
$3,348potential recovery · 31 claims
Review OpportunityPayer Performance
PayerFight ScorePayerFight ScoreMeasures payer financial performance based on reimbursement, denials, payment accuracy and administrative friction.
Horizon BCBSA
- Avg. reimbursement
- $148
- Denial rate
- 3.2%
- Underpayment rate
- 4.1%
- Days to payment
- 19 days
- Opportunity
- $7,406
AetnaB+
- Avg. reimbursement
- $132
- Denial rate
- 7.2%
- Underpayment rate
- 8.1%
- Days to payment
- 26 days
- Opportunity
- $10,840
CignaB
- Avg. reimbursement
- $128
- Denial rate
- 6.4%
- Underpayment rate
- 9.3%
- Days to payment
- 29 days
- Opportunity
- $8,721
UnitedHealthcareC-
- Avg. reimbursement
- $119
- Denial rate
- 11.8%
- Underpayment rate
- 14.2%
- Days to payment
- 34 days
- Opportunity
- $14,280
OscarC
- Avg. reimbursement
- $116
- Denial rate
- 9.6%
- Underpayment rate
- 12.4%
- Days to payment
- 38 days
- Opportunity
- $3,212