The Medicare Underpayment Detection Tool That Could Recover Thousands for Your Practice

Primary Care Perspective - Mississippi Edition | Wednesday, January 28, 2026

Strategic intelligence for independent primary care physicians in Mississippi.

Opening Insight

A recent acquisition in healthcare technology reveals a critical gap many independent practices are missing: systematic detection of Medicare underpayments, particularly in patient transfer scenarios. While this acquisition targets hospital systems, the underlying issue-Medicare revenue leakage-affects primary care practices across Mississippi, where you’re already operating on the nation’s lowest reimbursement rates and cannot afford to leave money on the table.

What’s Happening

Kodiak Solutions recently acquired BESLER & Company, a 40-year veteran in healthcare revenue recovery, specifically to integrate BESLER’s Transfer DRG software into its analytics platform. This specialized tool detects Medicare underpayments that slip through standard billing processes. The acquisition represents a broader industry trend: moving from fragmented point solutions to comprehensive platforms that can identify revenue leakage systematically.

BESLER’s Transfer DRG software focuses on one of the most commonly missed revenue opportunities-proper coding and billing when patients are transferred between care settings. The company has spent four decades perfecting methods to catch these errors before money is permanently lost. By combining this specialized detection capability with Kodiak’s broader net revenue reporting suite, the merged entity aims to help healthcare CFOs replace multiple vendors with a single, data-driven system that catches underpayments across the board.

The strategic message behind this acquisition is clear: healthcare providers of all sizes are leaving significant revenue on the table through coding gaps, underpayments, and billing errors that standard processes don’t catch. The companies consolidating these tools believe the future isn’t about having more vendors-it’s about having smarter systems that systematically identify every dollar you’ve earned but haven’t collected.

Why This Matters for Mississippi Independents

While Kodiak’s acquisition targets larger health systems, Mississippi independent practices face the same fundamental challenge-revenue leakage-but with even less margin for error. You’re operating in a state with the lowest Medicare reimbursement rates in the nation while managing the highest chronic disease burden, meaning your patient encounters are often complex and involve multiple diagnoses, transitions of care, and referrals that create billing complexity.

When BCBS Mississippi dominates your commercial payer mix and rural hospital closures are reshaping where you send patients, every transfer, every referral, and every care transition creates an opportunity for underpayment or missed billing. Without Medicaid expansion, your Medicare and high-deductible commercial patients make up a larger percentage of your revenue, making proper Medicare coding and payment verification even more critical to your practice survival.

For independent practices, revenue leakage typically occurs in three areas: missed charges for services actually rendered, undercoding complex visits to “play it safe,” and failure to appeal underpayments or denials because staff lacks capacity. Unlike hospital systems that can afford specialized revenue cycle platforms, you’re likely relying on your biller’s memory and your EHR’s basic scrubbing tools-neither of which systematically identifies money you’ve earned but haven’t collected.

Your Action Items This Week

1. Audit your last 50 Medicare claims for undercoding: Pull reports on your E/M level distribution and compare it to national benchmarks. If you’re billing 99213s at rates significantly higher than peers seeing similar patients, you’re likely leaving money on the table by undercoding complexity.

2. Review your patient transfer and referral workflows: Create a checklist ensuring that when you transfer patients to specialists, ERs, or hospitals, you’re billing appropriately for care coordination (99358-99359), transitional care management (99495-99496), or chronic care management services that Medicare pays separately.

3. Schedule a quarterly revenue leakage review with your biller: Set a recurring meeting specifically focused on denied claims, underpayments, and missed billing opportunities. Even recovering one additional $100 underpayment per week adds $5,200 annually to your bottom line.

Source

“Kodiak Solutions Acquires BESLER to Close the ‘Revenue Leakage’ Gap,” HIT Consultant

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