Discount or Payment Variance

A discount or payment variance is the difference between the expected and actual amount of a discount or payment. To qualify, there must be a variance of at least one dollar. Smaller variances are attributed to rounding.

Discount or payment variance can be expressed this way:

  • In dollars:
  • Expected Amount - Actual Amount
  • In percentages:
  • ((Expected Amount - Actual Amount)/Expected Amount) x 100

A negative variance is a result of accounts that are either overpaid or over-adjusted. If you had $5000.00 in billed charges with an expected payment of $3000.00, but the actual payment was $3100.00. The payment variance is -$100.00 because the insurance paid $100 more than expected and this amount is to be credited back to the insurance.

A variance with a positive value results when an account is underpaid or under-adjusted. If you had $5000.00 in billed charges with an expected payment of $3000.00, but the actual payment was $2100.00. The payment variance is $900.00 because the insurance only paid a partial amount (or waiting on patient payment), so you are expecting $900 more dollars to be paid on this underpaid account.

Refer to the following examples for completing the search criteria:

Not including a plus (+) or negative (-) assumes an absolute value.

  • Accounts that are overpaid or underpaid by more than $50, use criteria: payment variance > $50

  • Accounts that are overpaid or underpaid by less than $50, use criteria: payment variance < $50

Using a negative (-) sign finds accounts in either direction starting from that negative variance threshold.

  • Accounts that are overpaid more than $50 (where the negative number increases), use criteria: payment variance < $-50.00

  • Accounts that are overpaid less than $50 (this includes accounts paid accurately as well as underpaid accounts), use criteria: payment variance > $-50

Using a plus (+) sign finds accounts in either direction starting from that positive variance threshold.

  • Accounts that are underpaid more than $50, use criteria: payment variance > $+50.00

  • Accounts that are underpaid less than $50 (this includes accounts paid accurately as well as overpaid accounts), use criteria: payment variance < $+50