UNDERPAYMENT PLAYBOOK · PAID BELOW FEE SCHEDULE

How to recover a Paid Below Fee Schedule underpayment

A below-fee-schedule underpayment is when a payer pays a claim at less than the rate your contract says it should, and because the claim paid, nothing flags it. It's the purest form of silent lost revenue.

How it shows up: Allowed amount below your contracted rate — often with no denial code at all

Why it happens

  • The payer loaded your fee schedule wrong or defaulted to a lower rate
  • A contracted annual update or amendment was never applied
  • The claim priced to an out-of-network or older rate by mistake
  • The right rate exists in the contract but the payer's system didn't use it

What recovers it

  • Compare the allowed amount on each line to your contracted rate for that CPT
  • Submit the contract or fee-schedule page showing the correct rate and effective date
  • Request reprocessing to the contracted amount, back to the effective date
  • Reconcile every remittance line's allowed against contract, since there's no denial to catch it for you

Worth recovering? These are pure silent losses, the claim paid, so nothing surfaced them. A systematic allowed-versus-contract comparison is the only way they show up, and they repeat on every claim until the payer's fee schedule is fixed.

Common questions

How do I recover a Paid Below Fee Schedule underpayment?

A below-fee-schedule underpayment is when a payer pays a claim at less than the rate your contract says it should, and because the claim paid, nothing flags it. It's the purest form of silent lost revenue. To recover it: compare the allowed amount on each line to your contracted rate for that CPT; submit the contract or fee-schedule page showing the correct rate and effective date; request reprocessing to the contracted amount, back to the effective date; reconcile every remittance line's allowed against contract, since there's no denial to catch it for you. Because the claim already paid, the hard part is catching it, reconciling the allowed amount against what you were actually owed.

Is a Paid Below Fee Schedule underpayment worth recovering?

These are pure silent losses, the claim paid, so nothing surfaced them. A systematic allowed-versus-contract comparison is the only way they show up, and they repeat on every claim until the payer's fee schedule is fixed. A no-risk service makes it easy to find out, you only pay on what's actually recovered, so there's no cost to surfacing the ones that are real.

How does Volari find Paid Below Fee Schedule underpayments?

Volari reconciles every remittance line's paid and allowed amounts against what your contract and the payer's own rules say you should have been paid, surfaces the paid below fee schedule shortfalls no one flagged, and works the recovery. You pay 25% only on what's recovered, and nothing if nothing comes back.

Other underpayment types
Multiple Procedure Payment Reduction (MPPR)Modifier Payment Reductions (Bilateral, Assistant, Co-Surgeon)Bundling That Reduced PaymentSequestration Over-AppliedSilent PPO / Rental Network RepricingSecondary / COB ShortfallOutdated or Wrong Fee ScheduleOut-of-Network UnderpaymentE/M Downcoding UnderpaymentDrug / J-Code UnderpaymentMissing Prompt-Pay InterestRecoupment & Offset ErrorsSite-of-Service Payment Differential"Lesser of Billed Charges" TrapTC/26 Professional-Technical Split Paid WrongGlobal-Period Payment Errors

Volari's AI agentic crew that works your pile

The same AI agents that reconcile every line and recover your paid below fee schedule underpayments inside the app, each a specialist at one part of the fight, paid only on what they bring back.

Reva
Lead
Cody
Coding
Denny
Appeals
Faye
Follow-up
Iris
Intel

See what you were underpaid, line by line.

Upload your remittances and Volari reconciles every paid amount against what you were owed. No risk, paid only on what we recover.

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