Fictional TRH demo data — no PHI
Harsight VERIFY
← Spend exceptions
TRH demo record · fictionalUnderpaymentPayer underpaymentmedium severityhigh confidence

Implant carve-out not applied on two surgical claims.

EX-2003 · opened 2026-06-28 (21d) · UnitedHealthcare

$38,500
Recoverable (underpaid)

Three-way match

Recoverable (underpaid)
Contract term
$192,500
Contract fee schedule
835 variance batch UHC-Q3
Invoice / claim line
$154,000
Payer remittance (paid)
835 variance batch UHC-Q3
VERIFY expected
$192,500
Expected per fee schedule
VERIFY expected-vs-paid
Exact variance$38,500

Paid 154000 vs contracted 192500 → 38500 underpaid (recoverable from payer).

Baseline figures are illustrative demo values; the variance is the exact recoverable/avoidable amount VERIFY flagged.

Evidence & source

Evidence835 variance batch UHC-Q3
CategoryPayer underpayment
Owner (record)C. Ford
Status (record)Open
Linked agreementCommercial Payer Participation Agreement (AGR-UHC-001)
Download evidence (CSV)Download contract (PDF)

Chronology

  1. Flagged by VERIFY
    Underpayment detected against contract evidence: 835 variance batch UHC-Q3.
    2026-06-28
    done
  2. Assigned for triage
    Routed to C. Ford for review.
    2026-06-28
    done
  3. Current status: Open
    Under active reconciliation with the counterparty.
    2026-06-28
    current
  4. Next: recover / dispute
    Request credit, open a dispute, or accept as expected — demo actions below.
    —
    pending

Resolution workflow

Open
Interactive demo — actions are in-memory only and reset on reload; nothing is written to any store.
of $38,500 flagged

Notes

0

No notes yet.

Other exceptions · UnitedHealthcare

3
  • Underpayment
    Down-code pattern on outpatient E/M claims below fee schedule.
    $96,500
  • Denial variance
    Elevated no-authorization denials vs. contract policy.
    $61,000
  • SLA breach
    Clean-claim adjudication exceeding 21-day contract window.
    $18,000