Calderwood Health System

8 payers · 3 locations · Apr 2025 – May 2026

Analyze your own data

Lines analyzed

85,000

across all remittances

Underpaid lines

6,898

8.1% of total

Total underpayment

$2,015,871

paid below contracted rate

Estimated recoverable

$1,310,316

at 65% recovery assumption

Underpayment by payer

Top 10

Underpaid CPT codes

Monthly underpayment trend

Recent uploads

File	Period	Status
calderwood_era_2026_05.835	May 1 – May 31, 2026	Complete
calderwood_era_2026_04.835	Apr 1 – Apr 30, 2026	Complete
calderwood_era_2026_03.835	Mar 1 – Mar 31, 2026	Complete
calderwood_era_2026_02.835	Feb 1 – Feb 28, 2026	Complete
calderwood_era_2026_01.835	Jan 1 – Jan 31, 2026	Complete

Detected patterns

5 findings

Corion Health Plan · CPT 47562 · modifier LT

Corion Health Plan pays 47562 at 77 % with modifier RT but only 65 % with modifier LT. Review modifier billing and payer adjudication for this combination.

Audit 47562 modifier-LT claims to Corion Health Plan and appeal the short-paid lines.

$8,575

10 claims

Westmark Health Plan · CPT 99285 · modifier 25

Westmark Health Plan pays 99285 at 90 % with modifier (none) but only 63 % with modifier 25. Review modifier billing and payer adjudication for this combination.

Audit 99285 modifier-25 claims to Westmark Health Plan and appeal the short-paid lines.

$7,070

72 claims

Westmark Health Plan · CPT 99223 · modifier 25

Westmark Health Plan pays 99223 at 90 % with modifier (none) but only 64 % with modifier 25. Review modifier billing and payer adjudication for this combination.

Audit 99223 modifier-25 claims to Westmark Health Plan and appeal the short-paid lines.

$5,019

69 claims

Westmark Health Plan · CPT 99205 · modifier 25

Westmark Health Plan pays 99205 at 91 % with modifier (none) but only 64 % with modifier 25. Review modifier billing and payer adjudication for this combination.

Audit 99205 modifier-25 claims to Westmark Health Plan and appeal the short-paid lines.

$4,356

62 claims

Westmark Health Plan · CPT 99233 · modifier 25

Westmark Health Plan pays 99233 at 90 % with modifier (none) but only 79 % with modifier 25. Review modifier billing and payer adjudication for this combination.

Audit 99233 modifier-25 claims to Westmark Health Plan and appeal the short-paid lines.

$2,211

33 claims