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

Outpatient bundling edit applied against fee schedule.

EX-2010 · opened 2026-06-15 (34d) · Blue Cross and Blue Shield of Texas

$88,500
Recoverable (underpaid)

Three-way match

Recoverable (underpaid)
Contract term
$442,500
Contract fee schedule
835 variance batch BX-Q3
Invoice / claim line
$354,000
Payer remittance (paid)
835 variance batch BX-Q3
VERIFY expected
$442,500
Expected per fee schedule
VERIFY expected-vs-paid
Exact variance$88,500

Paid 354000 vs contracted 442500 → 88500 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 BX-Q3
CategoryPayer underpayment
Owner (record)C. Ford
Status (record)In review
Linked agreementStatewide Blue Plan Participation Agreement (AGR-BX-001)
Download evidence (CSV)Download contract (PDF)

Chronology

  1. Flagged by VERIFY
    Underpayment detected against contract evidence: 835 variance batch BX-Q3.
    2026-06-15
    done
  2. Assigned for triage
    Routed to C. Ford for review.
    2026-06-15
    done
  3. Current status: In review
    Under active reconciliation with the counterparty.
    2026-06-15
    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 $88,500 flagged

Notes

0

No notes yet.

Other exceptions · Blue Cross and Blue Shield of Texas

2
  • Denial variance
    Timely-filing denials on resubmitted secondary claims.
    $33,000
  • Underpayment
    Observation-rate variance on short-stay claims.
    $22,000