Underpayment Recovery That Finds What Others Miss
Intelligent detection and recovery for hidden underpayments. Advanced analytics, national payer intelligence, and reimbursement expertise uncover missed revenue in zero-balance accounts and complex payment discrepancies.
Recovery That Converts to Cash
Underpayments hide in zero-balance accounts, blend into contractual adjustments, and persist after claims are considered resolved. Most organizations don't know how much is there — because standard tools were never built to find it. Revecore was.
Our Approach
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Reimbursement Expertise
Dozens of specialized expert teams, unmatched in the market. Hundreds of analysts, nurses, and reimbursement specialists with deep experience across DRGs, coding, payment policy, and reimbursement nuance.
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Proven Performance
Recovery performance 2–3x higher than variance-only approaches. Cycles as low as 30 days for high-probability commercial claims.
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Proprietary Technology & Payer Intelligence
Thousands of proprietary algorithms and pricing engines informed by 25+ years of operating expertise. ML-based prioritization and cross-client payer intelligence that no single hospital could build alone.
How Underpayment Recovery Works
Intelligence-Led to Turn Underpayments From Invisible Loss Into Recoverable Revenue
AI-Enabled Claim Scoring
Proprietary algorithms and machine learning surface underpayments that standard tools and variance-only approaches miss, including discrepancies that hide in zero-balance accounts after claims are considered closed.
Precision Prioritization
AI-driven scoring ranks every claim by recovery likelihood, financial impact, and payer behavior patterns — automatically applying client-specific scope rules so specialist effort is concentrated where recovery is both meaningful and achievable.
Expert-Led Recovery
AI accelerates the recovery process — streamlining claim analysis and routing — while specialized teams of certified coders, RNs, reimbursement analysts, and attorneys drive every claim to final resolution.
Placed Variance
Revecore's placed variance support keeps placed accounts moving, protects in-flight revenue, and surfaces the pricing errors quietly eroding your bottom line, closing the coverage gap between active A/R and zero-balance scope.
Continuous Intelligence
Recovery results continuously feed back into detection models, so identification logic evolves as payer behavior changes, emerging patterns are caught earlier, and payment accuracy improves over time.
Where Underpayments Hide
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Contractual Underpayments and Pricing Discrepancies
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Coding & DRG Misalignment
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Payer Policy Misapplication
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Misclassified or Hidden Zero-Balance Denials
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Line-item Underpayments and Bundled Payment Errors
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Emerging Payer Behavior Patterns and More
Case Study: Southern Health System
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Challenge
A nine-facility health system in the South had a dedicated internal underpayment team working claims through their own variance tool. The program was functioning — but leadership wanted to be certain revenue wasn't slipping through gaps their tool couldn't see. They needed a partner who could work alongside their team and surface what a variance-only approach consistently misses.
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Solution
The health system engaged Revecore to supplement their internal team. Revecore deployed a multi-prong approach — payment variance, billing and coding review, and zero-balance denial recovery — on accounts outside the reach of their variance tool. The result: $11.7 million in cash recovered that the health system's program wouldn't have found on its own.
Results
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$11.7M recovered working behind the internal underpayment team
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Recovery spanned payment variance, billing and coding, and zero-balance denials
The Revecore Difference
What Other Vendors Miss, Revecore Recovers
Specialized Expert Teams
Depth no generalist vendor can replicate — hundreds of analysts, nurses, reimbursement specialists, and attorneys by claim type.
2,000+ Proprietary Algorithms
25+ years of underpayment data hardcoded into detection logic, surfacing what contract variance tools consistently miss.
Technology-Enforced Scope
Scope control hardcoded at the claim level to align with client specifications.
National Payer Intelligence
Cross-client learnings from 750M+ claims drive detection logic that no single hospital could build — or buy — anywhere else.
Underpayment Prevention
Prevention alongside recovery with root-cause insights fed directly into contracting and revenue integrity initiatives.
Delivering Meaningful Underpayment Recovery
420%
ROI on underpayment recovery.
Up to 3x
Higher recovery versus variance-only approaches.
30 Days
Faster recovery cycles for high-probability claims.
750M+
Claims informing every actionable insight.
Frequently Asked Questions
What exactly is an underpayment?
Underpayments occur when a payer reimburses less than contractually agreed or clinically justified — often without a formal denial — and close at zero balance, creating the appearance of resolution when revenue has been left behind.
Why are underpayments so difficult to detect?
Standard tools are built for open balances and formal denials. Underpayments hide in zero-balance accounts and persist after claims are considered resolved — exactly the gap those tools were never designed to detect.
What types of underpayments does Revecore identify?
Contractual discrepancies, coding and DRG misalignment, payer policy misapplication, hidden denials adjusted to zero balance, line-item and bundled payment errors, and payer behavior patterns identified through cross-client analytics.
How is Revecore different from contract variance tools?
Contract variance catches claims paid below the contracted rate. Revecore also surfaces coding-driven underpayments, zero-balance hidden denials, and payer behavior patterns that only emerge at national scale — delivering 2–3x higher recovery.
Does Revecore help prevent future underpayments?
Yes. Root-cause analytics identify payer behaviors driving repeat underpayments — feeding into contracting and revenue integrity work. Recovery volumes typically stabilize over time as those root causes are addressed.
Find Out How Much Is Hidden in Your Zero-Balance Accounts.
Connect with a Revecore specialist to benchmark your payer performance and identify where revenue is quietly slipping through.