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Revenue Opportunities

Aetna — Contract reimbursement variance

Contract Variance

Potential recovery
$1,200
19 affected claimsHigh confidence

PayerFight detected that these claims appear inconsistent with the reimbursement terms currently on file for this payer.

The financial difference

Contracted reimbursement$155.00benchmark per service
Average actual reimbursement$132.00benchmark per service
Average difference$23.00illustrative benchmark

The comparison above illustrates the reimbursement benchmark. This opportunity also includes denial or payment adjustments, so its potential recovery is not calculated from the benchmark alone.

Affected claims

19 claims identified for review

Claim IDProviderDate of ServiceCPTBilledExpectedPaidDifferenceStatus
19 claims are included in this synthetic aggregate finding. Claim-level evidence is available when you prepare the recovery case.