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

Observation-rate variance on short-stay claims.

EX-2012 · opened 2026-06-29 (20d) · Blue Cross and Blue Shield of Texas

$22,000
Recoverable (underpaid)

Three-way match

Recoverable (underpaid)
Contract term
$110,000
Contract fee schedule
835 variance batch BX-Q3
Invoice / claim line
$88,000
Payer remittance (paid)
835 variance batch BX-Q3
VERIFY expected
$110,000
Expected per fee schedule
VERIFY expected-vs-paid
Exact variance$22,000

Paid 88000 vs contracted 110000 → 22000 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)Open
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.
    2026-06-29
    done
  2. Assigned for triage
    Routed to C. Ford for review.
    2026-06-29
    done
  3. Current status: Open
    Under active reconciliation with the counterparty.
    2026-06-29
    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 $22,000 flagged

Notes

0

No notes yet.

Other exceptions · Blue Cross and Blue Shield of Texas

2
  • Underpayment
    Outpatient bundling edit applied against fee schedule.
    $88,500
  • Denial variance
    Timely-filing denials on resubmitted secondary claims.
    $33,000