NetDirect Health monitors your workers' comp reimbursements, flags every underpayment, and generates the dispute packages to get your money back.
Here’s what’s happening: network repricing vendors buy access to your TIN for a few dollars per claim. They match your tax ID against a leased database, flag the claim as “in-network,” and apply a discount — even if you never signed a contract with them and never received a patient referral through their network.
Your EOB shows up with a smaller number. Your billing team posts the payment and moves on. Nobody disputes it because nobody flagged it.
For a typical orthopedic or surgical practice doing 150+ WC cases per year, this adds up to $50,000–$200,000 annually in underpayments that go completely unnoticed.
Export your claims data from Athena, eClinicalWorks, NextGen, or any PMS that produces a CSV or ERA/835 file. Upload it to NDH. We also accept EOB PDFs.
First upload? We’ll walk you through it on a 30-minute onboarding call. Most practices are set up and seeing results within 48 hours.
Our engine compares every claim against the state WC fee schedule, Medicare benchmarks, and your uploaded contracts. Claims paid below threshold get flagged with the gap amount, the repricing entity responsible, and the legal basis for dispute.
You get a monthly report showing exactly what you’re owed and from whom.
For every flagged claim, NDH generates a ready-to-send dispute package: demand letter with your practice letterhead, state-specific forms (WC-14, SCWCC Medical Bill Dispute, etc.), evidence documentation, and a copy-paste email template.
Print it. Send it. Get paid.
The NDH portal walks you through the entire recovery process step by step. Upload your data, watch the analysis unfold, and download your dispute packages — all in one place.
Drag and drop your ERA/835 files, CSV exports, or EOB PDFs. The parser handles the rest.
Upload payer contracts and PPO agreements. AI reads them and auto-fills your contracted rates.
Dial in your underpayment sensitivity — % of fee schedule, % of Medicare, minimum gap amount.
Watch your numbers come to life — total claims loaded, flagged vs. clear, recovery potential, all animated as you scroll through.
See underpayments broken out by billing code category and sorted by which payers owe you the most.
Filter, review, and bulk-select claims. Generate demand letters, evidence packages, and state forms — download everything as a ZIP.
Pre-loaded with sample data. No login required.
Select a state to access WC fee schedule benchmarks, CMS Medicare rates, and commercial payer data from MRF filings — all in one lookup tool.
Automated comparison of every WC claim against state fee schedules, Medicare rates, and your contract terms. Flagged claims include the gap amount, repricing entity, and severity score.
Upload your payer and network contracts. Our AI reads them and determines whether each discount was actually authorized. No more guessing if that PPO rate was legitimate.
Demand letters pre-populated with your practice info, the specific claims at issue, the legal basis under your state's WC statute, and the dollar amount owed. Ready to print and send.
Georgia WC-14 petitions. South Carolina SCWCC medical bill disputes. North Carolina IC filings. Virginia WCC forms. Pre-filled with your claim data. No manual entry.
Each dispute includes a compiled evidence file: the EOB/ERA excerpt, fee schedule printout for the relevant CPT codes, contract clause (if applicable), and benchmark comparison. Everything the carrier needs to process the reconsideration.
This isn't a one-time audit. Upload new claims data each month and NDH catches new underpayments as they happen. Continuous monitoring means continuous recovery.
Most practices don't know how much they're losing because nobody's checking. Our estimator gives you a ballpark in 30 seconds based on your specialty, state, and WC case volume. No login. No email required.
If you're a billing manager, office administrator, or practice owner dealing with WC reimbursements that don't add up — this is for you. NDH is designed for practices that don't have a dedicated revenue recovery team and don't want to hire one.
We handle PHI. We take that seriously.
All data encrypted at rest and in transit. Our infrastructure runs on HIPAA-eligible cloud services with full audit logging.
We sign a Business Associate Agreement with every customer before any data is uploaded. No exceptions.
Your claims data is yours. We don't sell it, share it, or use it for anything other than running your analysis.
We only ingest the fields needed for underpayment analysis. We don't need patient SSNs, clinical notes, or medical records.
We'll walk you through the platform, run a sample analysis on your claims data, and show you exactly where your practice is losing money to repricing. No commitment required.
Or email us directly at adam.grove@netdirecthealth.com