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Underpayment Dispute Letter

When the payer paid less than the contracted rate. Tie your dispute to the fee schedule or contract term — vague dispute letters get ignored.

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📋 Before you send Confirm your contracted rate vs. what was paid — pull the EOB and your contract fee schedule. Identify the specific contract section governing payment for the service. Most state prompt payment laws require resolution within 30–45 days of a written dispute.

TODAY'S DATE

PAYER NAME
Provider Relations / Claims Dispute Department
PAYER ADDRESS OR FAX


RE: Formal Underpayment Dispute — Request for Reprocessing
Provider: PROVIDER / FACILITY NAME
NPI: NPI | Tax ID: TAX ID
Contract Effective Date: CONTRACT DATE
Patient: PATIENT NAME
Member ID: MEMBER ID
Claim Number(s): CLAIM NUMBER(S)
Date(s) of Service: DOS
Service: CPT CODE — DESCRIPTION


Dear Provider Relations Department,

This letter constitutes a formal dispute regarding the underpayment of the above-referenced claim(s). Payment was received on DATE PAYMENT RECEIVED in the amount of $AMOUNT PAID. Based on our participation agreement and the applicable fee schedule, the correct payment for this service is $CONTRACTUALLY OWED AMOUNT — a discrepancy of $UNDERPAYMENT AMOUNT.

Payment Discrepancy Summary:

CPT Code Date of Service Contracted Rate Amount Paid Underpayment
CODE DATE $RATE $PAID $DIFFERENCE
CODE DATE $RATE $PAID $DIFFERENCE
Total Underpayment $TOTAL

Contractual Basis:

Per our participating provider agreement with PAYER NAME, executed on CONTRACT DATE, services billed under CPT CODE are reimbursed at RATE DESCRIPTION — e.g., "100% of the 2024 Medicare Physician Fee Schedule" / "the fee schedule rate of $X as amended on [DATE]". A copy of the applicable fee schedule section is enclosed.

IF APPLICABLE: This payment also appears to be inconsistent with [PAYER NAME]'s own remittance advice, which indicates the allowed amount as $[X] but applied an incorrect reduction of $[Y] without contractual basis.

Request:

We request that PAYER NAME reprocess the above claim(s) and issue additional payment of $TOTAL UNDERPAYMENT within APPLICABLE TIMEFRAME — e.g., "30 days, consistent with [State] prompt payment requirements". If you believe the payment was correct, please provide written explanation citing the specific contract provision supporting the reduced rate.

Enclosures:

Sincerely,

SIGNATORY NAME, CREDENTIALS
TITLE
ORGANIZATION
PHONE | EMAIL

🔍 Search Fee Schedule Policy

Know before you dispute

Search Axlow for your payer's reimbursement policies, fee schedule methodology, and bundling rules — before you file a dispute, confirm the contractual basis.

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