How to recover a Sequestration Over-Applied underpayment
Sequestration is a 2% reduction that applies to Medicare and Medicare Advantage payments. It becomes an underpayment when a commercial payer takes the 2% with no basis, or when it's double-applied.
How it shows up: CARC 253 — roughly a 2% reductionWhy it happens
- A commercial payer applied sequestration with no contractual basis
- The 2% was double-taken
- It was applied to a non-Medicare line
- The reduction percentage was wrong
What recovers it
- Confirm sequestration applies only to Medicare and Medicare Advantage, not commercial plans
- Show the commercial payer has no contractual basis for the reduction
- Request the 2% back on the commercial lines
- Verify it wasn't taken twice on the same payment
Worth recovering? Two percent sounds small, but across high claim volume it compounds, and a commercial payer applying sequestration at all is frequently a clean, plainly recoverable error.
Common questions
How do I recover a Sequestration Over-Applied underpayment?
Sequestration is a 2% reduction that applies to Medicare and Medicare Advantage payments. It becomes an underpayment when a commercial payer takes the 2% with no basis, or when it's double-applied. To recover it: confirm sequestration applies only to Medicare and Medicare Advantage, not commercial plans; show the commercial payer has no contractual basis for the reduction; request the 2% back on the commercial lines; verify it wasn't taken twice on the same payment. Because the claim already paid, the hard part is catching it, reconciling the allowed amount against what you were actually owed.
Is a Sequestration Over-Applied underpayment worth recovering?
Two percent sounds small, but across high claim volume it compounds, and a commercial payer applying sequestration at all is frequently a clean, plainly recoverable error. 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 Sequestration Over-Applied 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 sequestration over-applied shortfalls no one flagged, and works the recovery. You pay 25% only on what's recovered, and nothing if nothing comes back.
Volari's AI agentic crew that works your pile
The same AI agents that reconcile every line and recover your sequestration over-applied underpayments inside the app, each a specialist at one part of the fight, paid only on what they bring back.
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.