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Reimbursement Variance Calculator

Compare one payer’s expected responsibility with recorded payments. Account for patient shares and additional payments without double counting.

No account requiredFormula and limits
Your numbers stay in this browser. Do not enter patient names, birth dates, member IDs, claim identifiers, medical record numbers or other protected health information. No upload or account is needed.

Enter your figures

Try a worked example, or enter your own non-identifying totals.

Use the allowance you expect—not the billed charge.
Enter the expected patient share, even if it is zero.
Exclude patient payments and supplements entered below.
Optional. Blank = zero. Supply the allocation; we do not calculate benefits.
Optional. Blank = zero. Do not count a payment already included above.

USD · Up to 2 decimal places · Calculation v1.0.0
Use 1,234.56 or 1234,56. Do not enter patient information.

YOUR RESULT

Your result will appear here.

Enter the figures above and calculate, or load the worked example.

What the result means

The calculator compares one payer’s expected share with the payments you enter. A positive result is a difference to review; a negative result means the entered payments exceed the expectation. Neither establishes an underpayment or overpayment on its own.

Which amounts to enter

Use the expected allowed amount, not the billed charge. Subtract the established patient and other-payer shares, then include payments from the payer being checked. Keep all figures within the same case or reporting group and observation period.

If an additional payment is already included in the main total, leave the additional-payment field at zero. Required fields need a value, including zero where appropriate; the two optional fields default to zero.

Try the $740 example

Select Load example, then Calculate difference. An allowance of $5,720 less a $250 patient share leaves $5,470 expected from the payer. A $4,730 payment leaves a $740 difference.

Add $600 in the additional-payment field and calculate again: the remaining difference becomes $140. These figures illustrate the calculation.

Before following up

Check the allowance source, responsibility split and payment history. The tool flags an allocation greater than the allowance and displays matches within one cent. That tolerance is a comparison aid, not a write-off instruction.

When to use a fuller reconciliation

Reversals, provider-level offsets and deposits covering several claims need a ledger that can match those transactions. This worksheet accepts non-negative payment amounts and does not import remittances. See CMS remittance guidance for the role of adjustment information.

Follow the full payment example or check the formula and rounding.

Print the result or copy it with the inputs for your review. Changing a value marks the previous result as outdated until you calculate again.

Your inputs stay in your browser

Financial values are not sent to analytics, placed in the URL or attached to an Ask DueMD question. Use totals that cannot identify a patient; do not enter patient details.

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Calculator values are not attached. Leave out patient and confidential information.