Leak 2: Underpayments

The second leak: 3-7% paid below contract—every payer, every month

A payer sends $847. Your contract says $923. Your EHR posts $847. The $76 difference disappears.

At $25M in revenue, that gap represents $750K to $1.25M in annual losses. In high-complexity specialties, the figure can reach 11%. ANKA checks every payment against every payer contract, identifies the variance, and recovers what you’re owed. Contingency pricing—zero risk to you.

$76 One underpaid claim. Multiply by thousands. Your team didn’t catch it. ANKA does.
Underpayment Recovery Dashboard
Claims Checked
4,218
+12%
Variances Found
312
+8%
Recovered
$47,891
+23%
UNDERPAYMENT DETECTED
CLAIM #7203 Aetna PPO
CPT 99214 – Contract: $923 | Paid: $847
Variance: -$76
DISPUTE FILED
Auto-generated appeal submitted to Aetna portal
Pattern detected: CPT 99214 across 43 claims
Total variance: $3,268
100%
Of payments verified against contract
$100K+
Median first recovery per client
0%
Upfront cost or monthly fee
97%
Collection success rate
30 days
Average first recovery timeframe
The Silent Leakage Problem

3-7% of payments fall below contract. Most organizations never notice

Your billing team can’t manually verify every payment against 50+ payer contracts. Payers know this. The underpayment slips through. Your EHR posts it. The variance becomes invisible.

3–5%
Of net revenue lost to underpayments annually—silently.
$847 vs. $923
One claim. A $76 difference. Multiplied across thousands of claims per month.
$750K–$1.25M
Annual leakage at a $25M revenue practice. High-complexity specialties: $2.75M+.
11%
Revenue loss in pain management, anesthesia, and specialty procedures. the highest-risk segments.
Zero
Current tools in most practices that catch this. EHRs don’t. Billing staff can’t. Standard RCM software misses it.

The math is clear. The solution is ANKA.

Calculate Your ROI
How ANKA Recovers It

Execution in five steps. No meetings. No consultants. Just work

1

Maps contracts

ANKA ingests every payer contract. Fee schedules, modifier rules, allowed amounts, and billing code dependencies—everything that defines what you should be paid.

2

Compares payments

Every incoming payment is checked against the applicable contract: Did the payer pay the correct amount for this code, this modifier, this patient status, and this timeframe?

3

Identifies variances

When the contracted amount doesn’t match the payment received, ANKA flags the discrepancy. It shows you the gap and quantifies exactly what you’re owed—and why the payer underpaid.

4

Assembles documentation

ANKA pulls the clinical evidence, contract language, and fee schedule excerpts and builds the case for recoupment without your team lifting a finger.

5

Submits & tracks

The submission goes to the payer. ANKA monitors the response, escalates if needed, and recovers the money. You see it posted. No follow-up is required from your side.

FAQs

Underpayment recovery

We accept fee schedules in any format: PDFs, Excel sheets, EDI 834 files, and direct payer API feeds. Our team ingests and maps them. You don’t build anything. The initial contract load typically takes 2–4 weeks, depending on the number of payers and the complexity of your billing structure.

We verify every flagged variance against the applicable contract, modifier rules, and patient eligibility at the time of service. False positives are rare because we are comparing exact payments against written contract terms. Our clients see a 97% collection success rate on identified variances—meaning payers agree and pay back what they owe.

First discovery: approximately 30 days into contract mapping. First recovery: typically 30–60 days after submission, depending on payer response time. Ongoing underpayments are flagged within 24 hours of payment posting.

No. You’re asking payers to honor their signed contracts. That’s not aggressive—that’s standard business practice. Our submission process is professional and documentation-driven, so payers can easily verify and pay. Many clients report that payers respect the formal, systematic approach. You’re not emotionally demanding; you’re contractually entitled.

Find out what you're losing

Complimentary revenue cycle assessment. If we don't find revenue worth recovering, you've confirmed your cycle is tight.

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