Medical billing underpayment calculator
Payers reprice quietly. Claims still post as “paid” — just for less. Estimate what that drift costs you in a year.
Estimated silent underpayment, annualized
$20,400 – $61,200
Based on $2,040,000 in annual allowed amounts at the industry rule-of-thumb 1–3% leakage rate. An estimate, not an audit — your actual number comes from your own 835 history.
Frequently asked questions
What is a silent payer underpayment?
A claim that posts as paid, but at a lower allowed amount than the payer previously paid for the same CPT — from quiet fee schedule changes, modifier reductions, or repricing. No denial, no flag; the money just stops arriving.
Why 1–3%?
Industry rules of thumb for net revenue leakage from underpayments cluster around 1–3% of allowed amounts. Your actual rate depends on payer mix and contract complexity — which is why the real number requires analyzing your own 835 remittance history.
How do I find my actual underpayment number?
Baseline each payer's historical allowed amount per CPT from your 835 files, then flag every line where the current allowed amount drifted below it. Remit Drift does exactly this — no contract loading required. The free audit takes 90 days of 835s and returns a variance report in 48 hours.