ANSWERS · PAYERS

How far back can I recover underpayments from a payer?

How far back you can recover depends on your contract and state law — commercial timely-filing and reprocessing windows commonly run 12 to 24 months, though some contracts and state prompt-pay laws allow longer. The practical limit is usually the contract's claim-dispute window, so the sooner you find a systematic underpayment, the more of the back-run you can still recover.

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What actually matters

  • Check your payer contract first — it sets the claim-dispute and reprocessing window that usually governs
  • State prompt-pay and unfair-claims laws can extend the window, sometimes to several years, and may add interest
  • Underpayments are systematic — one wrong loaded rate underpays every claim in that code family — so a back-run can be large once you find it
  • Self-funded (ERISA) plans follow the plan document, not state prompt-pay law, so their windows differ
  • The longer an underpayment goes undetected, the more of the earliest claims fall outside the window — detection speed is money

Common questions

Is there interest owed on underpaid claims?

Sometimes. Many state prompt-pay laws require interest when a payer pays late or below contract, and some contracts specify it. It's worth claiming alongside the principal on qualifying underpayments.

Where Volari fits: Volari's underpayment lane finds systematic below-contract payments and recovers the back-run to the contract's window — see your exposure at /underpayment-recovery.

Related answers
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