Britepath
Request an audit
Britepath
Request an audit

Did every claim turn into the money it should have?

Britepath reviews historical claims, payer activity, payments, and contract rules to identify where revenue appears underpaid, unpaid, missing, or left unexplained.

Request an auditSee how the audit works →
Claim 80421 · 11750Sample finding
Contract calculated
$156.00
Payer allowed
$156.00
Expected payer payment
$126.00
Payment found
$0.00
Potential missing payment
$126.00

Where revenue can break

We look for where the financial path broke

A claim can be priced right and still fail. These four problems need different evidence, different language, and usually different action — so they stay separate throughout the audit.

  1. 1

    The payer priced the claim incorrectly

    The applicable contract produces one amount. The payer allowed less. That may be a contract variance.

  2. 2

    The payer adjudicated the claim, but the money does not reconcile

    The remittance or adjudication indicates payer responsibility, but the corresponding payment is missing, incomplete, or not reconciled in the available posting data. That may be a payment variance.

  3. 3

    The claim or service line stopped before the financial path completed

    A claim, line, remittance, secondary claim, or other expected event appears to be missing from the next stage. That may be a processing gap.

  4. 4

    The payer followed the contract, but the contract is poor

    The payer appears to have paid according to the agreement, but the reimbursement level is materially below the selected benchmark. That is a contract opportunity, not a payment error.

How it works

We reconstruct what should have happened

The full method →
  1. Step 1

    We load the available history

    Claims, service lines, payer adjudication, remittances, payment posting, encounter data where available, and related financial activity.

  2. Step 2

    We load the rules

    Applicable contracts, contract versions, fee schedules, benchmarks, effective dates, and other rules required to interpret the claim.

  3. Step 3

    We reconstruct the financial path

    What was billed, submitted, adjudicated, what the contract produces, what the payer appears to owe, what payment evidence exists, and where the balance landed.

  4. Step 4

    We identify the breaks

    From the practice-level result down to the exact claim line, remittance, payment, contract rule, and source documents that support the finding.

What the practice receives

Start with the money, then show why

The first report is a financial review, not a dashboard. One number, separated by cause, with the claim-level evidence behind every material finding. Processing gaps are counted, never guessed into the total.

Everything the report contains →

Sample audit · Bigboy Podiatry (fictitious)Read it →
$219,225

Identified potential financial variance · 24 months · 41,286 claims

Contract variance
$128,640
Payment variance
$61,215
Other quantified gaps
$29,370
Processing gaps · amount unknown
164 records

Scope is evidence-dependent

We only call a finding what the evidence supports

Britepath works from the financial records and contract information available for the practice. When a source is missing or a conclusion cannot be supported, the result stays unresolved rather than being forced into a confident number.

After the audit

The audit is the beginning

Once the claims, payer activity, payments, and contract rules are structured, Britepath can help the practice understand payer performance, contract terms, denial patterns, payment reconciliation, recovery results, reimbursement by CPT, and other revenue-integrity issues.

Try the clickable demo →

Request a historical audit

Tell us about the practice. We will discuss the available claims, payer, payment, and contract data and what can be reviewed from the historical record.

Request an audit