Compare the contractually expected payment against what the payer actually paid — per claim, and scaled to monthly and annual exposure.
The leak nobody notices
Denials announce themselves; underpayments don’t. A claim paid at $500 against a $650 contractual expectation looks “paid” in every aging report — the $150 simply never arrives, claim after claim. Enter the expected and actual payments, and optionally how many similar claims a month you run, and this calculator returns the per-claim variance and what it compounds to.
How to use it
- Enter the expected payment from the payer contract or fee schedule.
- Enter the actual payment from the remittance.
- Add monthly claim volume to see the exposure at scale.
The formulas
A worked example
Expected $650, paid $500: a $150 underpayment — a 23.1% variance, far beyond rounding. At 40 similar claims a month that is $6,000 monthly and $72,000 a year from one payer-code combination alone, which is why underpayment detection consistently ranks among the highest-ROI activities in revenue cycle work: the money was already earned, contracted and billed.
Estimates only — payer contracts, plan documents and the EOB are always the source of truth, and nothing here is billing, legal or medical advice. The calculator runs entirely in your browser: no patient data is entered, transmitted or stored.