FORT Engine Processes Nearly 900,000 Medicare Records Across Three Specialties in Methodology Demonstration

The engine processed 884,901 procedure-level records and identified aggregate payment variance totaling over $4 billion across the three specialties analyzed. The demonstration applied FORT's Pass 3 remittance drift reconciliation — comparing Medicare allowed amounts against actual Medicare payments at the procedure level across nearly one million records.

Recoverable findings by specialty: Cardiology identified 482,671 recoverable records totaling $1,398,817,839. Ophthalmology identified 226,710 recoverable records totaling $2,357,076,308. Gastroenterology identified 146,292 recoverable records totaling $296,152,379.

Claims falling outside the 365-day Medicare timely filing window were classified as non-recoverable and excluded from recovery totals.

“Seeing FORT produce results of this scale and depth is genuinely exciting. The engine is doing the work of an entire analyst team in a fraction of the time, and the findings speak for themselves.”
— Aizan Gul, Managing Partner

The analysis was conducted on the publicly available CMS Medicare Physician and Other Practitioners by Provider and Service dataset published at data.cms.gov. It is presented as a demonstration of methodology and does not represent findings from a client engagement. The full case study is available at dataixai.com/case-studies.