Uncovering $34M in Underpayments Through Contract and Claims Data Alignment

Without FinThrive

Outdated payer fee schedules drove systemic underpayments over multiple years

Limited visibility into expected vs. actual reimbursement masked revenue leakage

Inability to validate payments made it difficult to challenge payer accuracy

Solution Highlights

Calculated accurate expected reimbursement across all payer contracts

Compared expected payments to actual remittances using integrated claims data

Uncovered systemic underpayment patterns tied to outdated fee schedules

Enabled finance and managed care teams to recover revenue with defensible data

Customer Overview

A U.S.-based hospital system used FinThrive Contract Manager and Claims solutions to analyze reimbursement accuracy across a five-year period. By aligning contract and claims data, the team identified systemic underpayments tied to delayed payer fee schedule updates.