A claim can be paid in full and still be underpaid. Your 835 just calls it done.
Denials get worked. Underpayments get posted. RecoveAR reconciles every 835 paid amount against the rate your contract actually promised, so the silent variance stops slipping through as revenue you already earned.
Underpayments hide because nothing in your workflow is looking for them
A denial throws a flag. It lands in an aging bucket, a worklist, a CARC code your team already knows how to fight. An underpayment does the opposite. The claim adjudicates, the 835 posts a payment, the patient balance settles, and the encounter closes as a win. No one reopens a claim that already paid.
The only way to know a paid line was short is to compare the posted amount to what the contract said it should have been, line by line, across every payer and every service. That comparison is exactly what most posting workflows skip.
RecoveAR reads the same X12 835 your team posts from, then re-prices every line against four independent benchmarks: your loaded payer contract fee schedule, the CMS CY2026 allowed amount for that code and setting, the No Surprises Act qualifying payment amount where it applies, and your own historical paid-rate for that payer. When posted falls below expected, it opens a variance the team can actually work.
Expected contract rate vs. what actually posted
Every card below is a paid claim. Not one was denied. The variance is the difference between the contracted allowed amount and the dollars the 835 actually posted, per line.
// Figures are illustrative archetypes for demonstration, not benchmark data. RecoveAR computes real variance from your loaded contracts and remits.
Four of five paid. Four of five short. Each one closed as complete.
The four steps that turn an underpayment into a closed claim
The 835 remittance advice reports what the payer decided to pay. On its own it never states what the payer was contractually obligated to pay. That single missing comparison is the whole leak.
Remit arrives
The 835 posts CLP and SVC segments with a payment amount. It reports the decision, not the contract.
Auto-posted
Payment reconciles to the expected charge, balance moves to zero, no CARC denial code fires.
Claim closed
The encounter leaves the worklist. Aging reports show it resolved. It reads as collected in full.
Variance stranded
The gap between allowed and posted never becomes a task. The dollars are earned, adjudicated, and never chased.
What "expected" is measured against, by name
A variance claim is only worth filing if the expected number is defensible. RecoveAR grounds every expected amount in a source you can cite back to the payer.
Your payer contract fee schedule
The loaded, rate-by-rate schedule from each executed payer agreement. This is the primary yardstick. Posted below the contracted allowed is a breach worth appealing.
Source: executed payer contractsCMS CY2026 allowed amounts
The Medicare Physician Fee Schedule Final Rule for CY2026, plus the OPPS and ASC Payment System Final Rule and the IPPS FY2026 Final Rule, used as the setting-correct floor and cross-check.
Source: CMS PFS / OPPS-ASC / IPPS 2026 final rulesNo Surprises Act QPA references
For out-of-network and balance-billing-protected services, the qualifying payment amount under the No Surprises Act (45 CFR Part 149) anchors what a reasonable payment should have been.
Source: No Surprises Act QPA, 45 CFR 149Your own paid-rate history
The historical posted rate for the same code and payer. When a line pays below its own trend, RecoveAR flags the drift even before a contract reload catches it.
Source: your 835 remittance historyFrom a posted 835 line to a filed variance appeal
RecoveAR sits on the same 835 feed your posting team already uses. It re-prices every paid line, ranks the variances by recoverable dollars and payer-response likelihood, and hands your team a worklist of paid-but-short claims with the contract citation and the benchmark already attached. Your AR staff spends its time filing, not hunting.
It runs on the reconciliation logic ASP-RCM already applies across specialties, from physician offices and therapy to ASC and behavioral health, so the same variance discipline covers your whole book instead of the one payer someone happened to audit last quarter.
Find out what your paid claims never told you.
Send us a sample 835 file and your contracted rates. We will show you, line by line, where posted fell below expected, and what that variance is worth to work.
Request a RecoveAR variance review → Talk to our AR teamGuideline references: CMS Medicare Physician Fee Schedule (PFS) CY2026 Final Rule; CMS Hospital OPPS and ASC Payment System CY2026 Final Rule; CMS IPPS FY2026 Final Rule; X12 835 Health Care Claim Payment/Advice (005010); No Surprises Act qualifying payment amount, 45 CFR Part 149. Dollar figures shown in the stat wall are illustrative archetypes for demonstration only and are not benchmark or client data.
ASP-RCM Solutions · Senior Partner · Frisco, Texas
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