Oscar — Reimbursement rate discrepancies
Potential Underpayment
Potential recovery
$1,200
PayerFight detected that these claims appear inconsistent with the reimbursement terms currently on file for this payer.
The financial difference
Contracted reimbursement$139.00benchmark per service
Average actual reimbursement$116.00benchmark 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
20 claims identified for review
| Claim ID | Provider | Date of Service | CPT | Billed | Expected | Paid | Difference | Status |
|---|
20 claims are included in this synthetic aggregate finding. Claim-level evidence is available when you prepare the recovery case.