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A billing error doesn't cost what the line says. It costs that — every month — until someone catches it.

TareSum is a monthly carrier bill audit for TPAs and brokers. We recompute every line of the bill from your enrollment data and the contract rates, and hand back the exceptions in dollars: who, which plan, which months, and exactly what the carrier owes back.

Start an audit See a sample audit

No system to install. No workflow change. A BAA before any file moves.

Why billing errors survive for months

Nobody re-derives a list bill line by line. The bill gets a totals-level sanity check, the total looks plausible, and it gets paid. That process has three structural blind spots — and each one gets more expensive with time.

BLIND SPOT 1

Errors repeat until corrected

A tier change the carrier never applied doesn't overcharge you once — it overcharges you again next month, and the month after. A single missed change routinely rides three to six bills before anyone notices, because nothing in the normal workflow ever recomputes the line.

BLIND SPOT 2

Retro windows close

Carrier contracts cap retroactive premium credits — commonly 60 or 90 days, sometimes two billing cycles. An overcharge caught in month one is fully recoverable. The same overcharge caught in month four is partly a permanent loss. The audit isn't just about finding errors; it's about finding them inside the window.

BLIND SPOT 3

Adjustments bury the evidence

One month's bill can carry retroactive corrections from six prior billing periods — credit/rebill pairs, partial adjustments, adjustments to adjustments. The section that's supposed to show corrections becomes the noise that hides the errors. Analysts skim it because reading it properly takes hours.

What one uncaught change costs

A real pattern from the sample audit: an employee drops spousal coverage effective May 1. The change is entered on time. The carrier keeps billing the old tier.

Bill month	Should bill (EE)	Carrier billed (EE+SP)	Overcharge	Cumulative
June	$320.09	$687.59	$367.50	$367.50
July	$320.09	$687.59	$367.50	$735.00
August	$320.09	$687.59	$367.50	$1,102.50

Each individual month is 0.3% of this group's bill — invisible at the totals level. By August it's a four-figure recovery, and if the contract has a 90-day retro cap, June is already at the edge of the window. The full breakdown, including what happens when a partial credit has already been applied →

The field guide: six ways a bill goes wrong

Written for the people who actually work these bills. Each one is a worked example — real math, line by line — from the same synthetic group as the sample audit, so you can check our arithmetic.

Retro adjustments

The retro window: why a May change is still costing you in August

Missed changes compound monthly, retro caps turn late catches into permanent losses, and the three-amount reconciliation that trips up every spreadsheet.

$1,102.50 in the sample audit

Terminations

Termed on June 30. Billed in July. And August.

Why "we sent the term file" isn't proof of anything, the cycle-cutoff trap, and how COBRA re-adds teach analysts to ignore exactly the wrong lines.

$640.18 in the sample audit

Volume-rated coverage

The decimal that multiplied a life premium by ten

Per-$100 vs. per-$1,000 rate bases, salary rounding, guarantee-issue caps — and why a 900% overcharge hides in plain sight next to a family medical premium.

$405.00 in the sample audit

Proration

Four correct premiums for the same person

Full month, daily proration, the 15th rule, first-of-following — all defensible, only one in your contract. The error is applying the wrong right answer.

$418.36 in the sample audit

Adjustment noise

The adjustment section is designed to be skimmed

Credit/rebill pairs that cancel to zero, pairs that don't — and how a "small net" adjustment section conceals real overcharges behind unrelated credits.

The one that hides the others

Under-billing

The employees who aren't on the bill (yet)

An under-charge feels like a win until the lump-sum back-bill arrives — or until a claim comes in for someone the carrier never enrolled.

−$928.26 in the sample audit

What one audit cycle looks like

A sample audit of one group — three months of bills checked against the enrollment record. Synthetic data, real math. 616 lines in, 13 exceptions out, every one drillable to the per-month arithmetic.

616

lines checked

600

clean

exceptions

$4,812.66

found in one cycle

Open the interactive sample audit →

How it works

STEP 1

Send the files you already have

Three inputs: your enrollment extract, your last three months of carrier bills, and whatever you have for rates and contract rules. Three months of bills because terminations, retro changes, and rate drift only prove out across bills, and 90 days is the recovery window most contracts allow. After the first cycle, each month's audit needs only that month's files. Any format — we map to yours. What to send and how →

STEP 2

We recompute every line

Tier by tier, effective date by effective date — including proration rules, volume-rated coverage, and retroactive changes against prior periods.

STEP 3

You get the exceptions

An audit report and a working exception workbook: who, what plan, which months, the exact dollar variance, and the evidence for the carrier dispute.

Why an audit, not another system

You already have enrollment systems and carrier feeds. What's missing is the check between them — someone recomputing what the bill should say before it's paid, every month, while recovery is still possible.

Everything you run today stays exactly where it is. There's nothing to implement, nothing to integrate, and nobody's workflow changes — the audit sits beside your process, not in it. If you ever stopped sending files, you'd simply stop getting audits; nothing else about your operation would notice.

TareSum is delivered monthly, priced per group, and cancelable any month. The first cycle is the proof: if we don't find anything worth the fee, that's a clean bill — and worth knowing.

Your files, however they arrive

Every carrier formats a list bill differently, and half the reason these errors survive is that nobody can get the bill and the census into the same shape. Normalizing that is the work we do — not a prerequisite you have to satisfy before we start. You send what you already have, in the format you already get it.

CSV / TSV / pipe Fixed-width XLS / XLSX EDI 834 EDI 820 / 835 XML / JSON Database extracts PDF & scanned bills bswift Employee Navigator PlanSource Selerix

INPUT 1

Enrollment

Your census or eligibility extract — member, plan, tier, effective and termination dates, plus salary or volume for life and disability lines. This is what we recompute from.

INPUT 2

Carrier bills

The list bills themselves, including the ancillary carriers that still send a PDF. Three months to start, then one per month.

INPUT 3

Rates & billing rules

Rate sheets and the rules in your carrier contracts — proration method, volume rate basis, retro credit window. This is what turns "unusual" into "the carrier owes you $367.50." Don't have it written down? We infer it from the bills and you confirm.

And four ways to move the files, from a one-time upload link to an authenticated API — pick the one your organization is comfortable with:

Level 1 — Manual

Secure upload link

Time-limited, write-only, scoped to your engagement. Nothing to install, no account to create. Ready the same day.

Level 2 — Managed transfer

SFTP, yours or ours

Key-based drops on our endpoint, or we pull from the secure share your team already runs for carrier files. Supports unattended monthly delivery.

Level 3 — Cloud storage

Direct container access

Azure Blob, S3, or GCS via a scoped-down container and short-lived credentials you issue and can revoke. No copy step.

Level 4 — Programmatic

REST API & scheduled pulls

Submit files and retrieve completed audit results as structured JSON, with webhook notification — so exceptions land in your systems instead of a workbook someone re-keys.

The interface never changes the audit — only how much handling it takes. The full intake detail: formats, mapping, validation, and what we don't need →

Moving files without a PHI problem

Census files and carrier bills contain protected health information. The transfer is designed around that fact — and around whatever file-movement tooling you already trust.

BEFORE ANYTHING

BAA first

We execute a business associate agreement before the first byte moves. No exploratory "just send us a sample" with real member data — ever. If you want to test the process first, we'll run it on a synthetic file.

Our standard BAA covers the terms your compliance team will look for: use of PHI limited strictly to performing the audit, no secondary use or disclosure, breach notification without unreasonable delay, subcontractor flow-down (our infrastructure runs on Microsoft Azure under Microsoft's HIPAA BAA), and return or destruction of your data when the engagement ends. If your organization has its own BAA form — most do — we'll sign yours instead. We don't make that a negotiation.

IN TRANSIT

Your channel or ours

Use the SFTP tooling your team already runs for carrier files, drop files on ours, or use a per-client secure upload link. If you have an existing secure share you control, we'll pull from it. The one thing we never do is accept PHI by email.

AT REST

Minimum necessary, then gone

Files are encrypted at rest, access is limited to the analysts on your audit, and source files are purged on a schedule you set after each audit is delivered. Your data exists with us to be audited, not accumulated.

Send us your last three months of bills.

One group, three months of bills, your enrollment files. Three months because that's the retro window — the errors worth money live across bills, and the clock to recover them is already running. We'll return the audit and walk you through every exception we found.

Start an audit

Four steps, and the first is a 20-minute call — no files, no member data. Or write to taresum@resoluteconcepts.com.