Payment Differences - Definition:
The Payment Difference is equal to the difference between the Plan Benefit calculated by the AnalyTXs AllPayor system and the plan benefit paid by the contracting payor.
The Payment Difference (including both underpayments and overpayments) are in system drill-down "payment differences reports" and can easily be individually researched and rebilled. Adjudication letters are automatically generated by the system and are contract specific and contain the calculation methodology, ICN number and other data necessary to advise the payor of the discrepancy and reason for resubmission. Claim records contain service dates and claim filed dates so our "contract specific" reporting can identify each claim potentially eligible for late penalties or interest.
