Medical Billing Underpayment Tracker Excel | Payer Recovery Audit Workbook

Find the payment gap. Verify the basis. Track the cash.

The MetricForgeHQ Payer Recovery Workbench gives medical billing and RCM teams a disciplined Excel workflow for reviewing suspected payer underpayments. It separates a calculated variance from evidence-validated exposure, tracks what was actually recovered, and keeps the remaining open balance visible. It is designed for a focused payer variance project, contract-rate review, or retro-recovery work queue.

What you receive
• Excel workbook with 200 prewired case rows, a live dashboard, editable payer-rule reference and a separate synthetic worked example.
• Five-page PDF guide covering setup, calculation logic, evidence review, follow-up, privacy and limitations.
• Editable text scripts for a payer call, written variance inquiry, escalation, leadership brief and weekly review agenda.

What it helps you do
1. Enter your organization's expected allowable, patient responsibility, permitted offsets and actual payer payment to calculate a suspected payer gap.
2. Verify the contract methodology, remittance and adjustments, dispute route, deadline, evidence packet and owner before a gap counts as validated exposure.
3. Sort action flags for missing inputs, upcoming or passed deadlines, duplicate work IDs and closed cases with an open balance.
4. Post later recovery cash separately from the variance and view the validated open amount. Enter your own recovery-probability assumption for an optional scenario forecast; it is not a guarantee or booked revenue.

Who it is for: medical billing managers, practice administrators, RCM analysts, recovery consultants and outsourced billing teams working with their own approved payer and contract records.

How to begin: Download and extract the ZIP. Open the workbook in a current desktop Excel version, read the Buyer Guide, set your payer rules and thresholds, then start on the Recovery Cases tab. The Worked Example uses invented amounts and is excluded from the live dashboard. The workbook does not ingest an ERA, adjudicate claims or supply current contract terms, payer deadlines or coding rules. You must validate those against your own agreements, remittances and current payer instructions.

Data and use: No patient data is included. The template asks for internal work IDs rather than patient names or claim numbers. An internal ID, dates, notes or supporting documents may still be identifiable in context; use the workbook only within your organization's approved environment and keep protected records in the authorized system. Do not send claim-level PHI through Etsy messages or to the seller. This is an operational template, not legal, coding, clinical or reimbursement advice.

License: One purchasing organization may use and adapt the files internally for its own operations. Do not resell, redistribute, sublicense or present the template as your own commercial product. No physical item will ship. Please message the shop about a download or file issue without including patient data.