System and Method for Fee Schedule Download, Comparison and Reconciliation Against Processed Medical Insurance Claims

A method of optimizing healthcare remittance processing, the method comprising:

• providing a data interface using a computer processor for storing CMS Fee Schedules in a database;
• receiving confidential payment and medical code claim information for storage in a HIPPA Compliant Secure Database;
• retrieving a payment and medical code claim from said HIPPA Compliant Secure Database;
• retrieving a corresponding medical code and payment amount from said CMS Fee Schedules database corresponding to patient demographics;
• performing a claims reconciliation and payment calculation by identifying, among other factors, payor, payee, treatment-specific fees schedule, and patient demographics such as age;
• generating a comparison of underpayments or overpayments or no payment based on said claims reconciliation and payment calculation.