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A denial shows up with a reason code. An underpayment shows up looking like a payment. The payer accepts the claim, pays less than the contract requires, and the account quietly closes at a zero balance. With algorithm-driven downcoding, inpatient stays paid at observation rates, and a year of fee schedule changes, those small shortfalls can repeat on every claim until someone goes looking.
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MD Clarity explains why sampling and single-rate systems miss these gaps, how AI agents can now check every remit against contract terms, and why recovering the money still takes people who know how payers work. You'll also find five steps to take before your next remit cycle.
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