The difference between what you were owed and what you got
Revenue integrity is arithmetic somebody has to be able to repeat. Attergo computes the expected payment for a dispensing event or a claim line from the contract term that governs it, holds the inputs that produced the number, and compares it against the remittance when the remittance arrives. The variance carries its own explanation.
A variance nobody can explain is a variance nobody works
Expected reimbursement is not one calculation. A fee schedule, a percentage of charges, a per diem, a case rate and a weighted payment are different arithmetics, and a single institutional claim can involve several at once. Approximate the ones you did not model and the variances stop being credible. Once they stop being credible they stop being worked, and the money that was recoverable simply ages out of the filing window.
The mechanism behind it.
The expectation is computed, not remembered
Each line resolves to the contract term that governs it, and the term, the rate basis and the inputs are stored with the result. The number is still explainable a year later, which is when somebody usually asks.
Remittances reconcile against what was expected
A remittance is matched to the lines it pays and the shortfall is attributed to a reason rather than left as a total. A difference with no reason attached cannot be appealed or renegotiated.
Tariff variance across payers, on one basis
The same item priced under several payer agreements is compared on a consistent basis, so a term that sits below the others is visible as a fact about the contract rather than as a run of bad months.
Every figure traces to the event that produced it
A variance links to the dispensing event, claim, remittance and contract behind it. The evidence is assembled by construction rather than reconstructed when somebody disputes the figure.
What an enterprise organization additionally gets.
Enterprise revenue integrity
These are enterprise surfaces. How they are packaged is on the pricing page, and nothing above them requires an enterprise organization to reach.