How providers can reclaim under-billed revenue by adopting payer-grade precision
For years, health systems have treated underpayments as a cost of doing business. But those missed dollars can be recovered, and the playbook already exists. Payers use AI-backed payment integrity programs to find overpayments. Providers can use similar methods to find what’s missing on their side. It doesn’t take massive tech investments – just focus, ownership, and a few smart moves.
This paper outlines three pragmatic moves any provider can take to uncover hidden revenue:
- Apply payer-grade analytical discipline to your own data.
- Start small with measurable pilots that prove results fast.
- Pair lightweight automation with clear operational accountability.
These moves expose underpayments, billing oversights, and unworked accounts: turning lost dollars into measurable cash and lasting process improvement.