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Still Trusting the Same Billing Reports While Losing $1M a Year?
Denials. Contract misinterpretations. Bundled payments gone wrong. They’re not bugs in the system. They are the system.
At HMS USA LLC, we don’t accept what payers offer. We go line by line, claim by claim, contract by contract—until we find the gap, and fill it.
And when we recover that lost revenue? You’ll wonder how you operated so long without us. Don’t call us unless you want to face the uncomfortable truth—and fix it.
TRUTH #1
Payers Are Trained to Pay You Less
They have analysts. You have overwhelmed billing staff. Guess who wins?
87% of hospital executives admit they lack real-time insight into claim underpayments.
CLAIM PAID*
*not in full
TRUTH #2
You're Not Tracking the Right Numbers
Your monthly billing reports show collections. Not losses.
Up to 3-5% of total revenue is lost to unnoticed underpayments every year.
$5,000,000
Annual Revenue
Revenue Evaporating
TRUTH #3
Most Billing Teams Don't Have Time to Investigate
Claim volume, denials, appeals... They're in survival mode—not recovery mode.
Less than 12% of denied claims are ever reworked after initial denial.
7 min
Time per claim
45 min
Time needed
"You think you're at 95% collection. You're actually at 85%.
The 10%? It's on the floor—and no one's picking it up."
Our Hospital Underpayment Recovery Service Is Built for Organizations Like Yours If…
You operate on thin margins, where every $1K matters
You've seen a spike in vague payer adjustments
Your billing team is maxed out and under-resourced
You haven't done a line-item audit in the past 12 months
You suspect underpayments but don't have proof.
Our best clients don't have a "collections" problem—they have a visibility
problem. And we solve it.
We Built a Healthcare Underpayment Recovery System That Leaves Nothing Behind
Contract-to-Claim Reconciliation
We match your contracted rates to each claim line to detect miscalculations.
Underpayment Pattern Detection
Our proprietary tools identify recurring underpayment trends across payers.
Clinical + Code Validation
We validate all modifiers, bundled codes, and challenge incorrectly grouped procedures.
Targeted Recovery Action
We re-open claims, file disputes, and escalate high-value cases for maximum recovery.
Transparent Reporting
We show you every dollar we recovered and where it was hiding.
5 Sources of Underpayments in Hospitals (That We Actively Recover)
Contractual
Miscalculations
Misapplied rates, outdated terms.
Modifier & CPT Code
Denials
Especially 25, 59, and 91 modifiers.
Bundled Payment
Confusion
Payments grouped without clinical logic.
Timely Filing
Errors
Payer misclassification, not actual late filing.
Secondary Payer
Fallout
Coordination of benefits issues no one tracks.
Most billing teams don't have the bandwidth—or the systems—to track this level of detail. That's where we come in
What Makes HMS USA LLC Different?
Feature Comparison
| Your Billing Vendor Closes Claims. We Recover What They Miss | ||
|---|---|---|
| Other Billing Vendors | HMS USA LLC | |
Audit depth
|
 High-level summary |
 Line-by-line forensic review |
|
Underpayment recovery
|
Optional / ignored |
Core service |
|
Denial management
|
Reactive |
Proactive + contract-driven |
|
Payer negotiation
|
None |
Aggressive + data-backed |
|
Result
|
Surface-level clean-up |
Deep revenue recovery |
We Build Custom Recovery Algorithms Based on Your Contracts
Your payer contracts aren't generic. So why would your recovery process be?
At HMS USA LLC, we build:
Custom logic engines to match your contract language
Payment models specific to your CPT mix and DRG weights
Claim testing tools against actual historical payer behavior
That's why our hospital underpayment recovery rates consistently outperform industry norms—by 2.7x.
What a Hospital Audit Actually Uncovers
This Is What You See… vs What We See in a Hospital Underpayment Audit
| Your View (Before Audit) | HMS View (After Audit) | |
|---|---|---|
| Denial Rate: 7% |
2.1% of those denials are payer error
Financial Impact: $150K–$300K annually in recoverable denials for a mid-sized hospital |
|
| "Paid" Claims |
11% underpaid by $30–$125 per claim
Financial Impact: $200K–$400K annually in recoverable underpayments for a mid-sized hospital |
|
| Write-Offs due to "Contractual Adjustments" |
38% were based on inaccurate rate logic
Financial Impact: $150K–$350K annually in recoverable write-offs for a mid-sized hospital |
|
| Bundled Payments |
18% had missed unbundling opportunities
Financial Impact: $100K–$200K annually in missed revenue for a mid-sized hospital |
|
| Closed Cases |
14% were recoverable with minimal effort
Financial Impact: $50K–$150K annually in recoverable closed cases for a mid-sized hospital |
|
| Hover over each item to see the financial impact | ||
Why HMS USA LLC Is the Last Hospital Underpayment Recovery Partner You'll Ever Need
When you've had enough of vague reports, 'clean claims,' and passive revenue leakage, there's only one name that stands between your hospital and every underpaid dollar it's owed.
We Operate Outside the Red Tape
No slow approvals. No integration headaches. You give us access—we start recovering.
Contract-Specific Algorithms—Built by Us, For You
We reverse-engineer your payer contracts and build forensic audit tools around your exact language."
Line-Item Recovery. Not Just Denial Chasing.
Other vendors stop at denials. We go line by line, modifier by modifier, CPT by CPT.
Zero-Risk Engagement
You don't pay unless we find money. And when we do—you'll wonder how much you've already lost.
Real Reporting. No Fluff.
You'll see every dollar we recover,
how we found it,
and why it was missed.
We don't sell hope. We deliver audits, evidence, and bankable revenue.
Hospitals bring us in when they're ready to get serious about reclaiming what's theirs.
What Clients Say About Us
Below, you will find feedback from some of our cherished clients. We are proud to have helped them reach their business goals, and we appreciate the kind words they have shared about our services.
North Ocean Medical Group, P.C
5.0 Out of 5North Orchard Medicine PC
5.0 Out of 5Dr. Bryant Medical Practice PC
5.0 Out of 5Advanced Medical Office, PC
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