What the first scan compares
- Book of business: policy or plan identifier, carrier, accounting period and the minimum fields needed to calculate expected commission.
- Carrier statement: statement-line identifier, policy reference, amount, line type and period.
- Commission authority: the schedule, contract or written rate support that applies to the period under review.
- Later credits: subsequent payments or corrections are reconciled before any open amount is quantified.
What Recovery OS looks for
- Missing commission candidates: expected commission supported by evidence, the verified payment window has closed, and no matching payment appears.
- Short-paid commission candidates: paid commission is below the supported expected amount after verified adjustments and later credits.
- Chargeback evidence gaps: negative adjustments are held for review unless the basis and supporting event can be verified.
- Agency overpayment risk: amounts paid above expectation are separated from recoverable value because they may be money the agency owes back.
A flagged amount is not recovered cash, and it is not proof that a carrier owes the agency money. Carrier acceptance, contractual interpretation and settlement remain separate steps.
Minimum data for a bounded pilot
A practical first pass can begin with masked or internal policy identifiers, carrier, period, commission basis, expected-rate support and statement amounts. Customer names, Social Security numbers, credentials and unrelated policyholder data should not be sent through the public site.
Why this fits the Recovery OS model
Commission reconciliation is a repeatable evidence problem: expected amount → statement amount → adjustments → later credits → open discrepancy. That is the same shared architecture used for freight, AP and contract entitlements, with an insurance-specific adapter rather than a separate software stack.
What happens after a finding
Human review confirms the source records and any carrier-specific terms. CashAudit AI does not automatically contact carriers, submit disputes, change producer payouts or write into an AMS.
Current commercial status
This lane is in service-assisted pilot scope review. Freight remains the primary live paid Recovery Scan while the insurance adapter is validated with synthetic QA and bounded customer scopes.
FAQ
Do I need Applied Epic, AMS360, HawkSoft or another integration?
No for the first review. The workflow is deliberately file-based and read-only.
Can PDFs be used?
Yes for analyst-assisted normalization when the statement is text-readable, but structured CSV/XLSX exports are preferred because they reduce mapping ambiguity.
Can the public form receive carrier statements?
No. Use the public channel for scope only. Supporting files belong in an approved private intake path after fit and handling requirements are confirmed.
Is a duplicate payment a recovery?
Not necessarily. If the carrier paid the agency too much, that is a liability or reconciliation issue, not a recovery candidate. Recovery OS keeps those states separate.