If the payment to a provider is more or less than the expected amount, what term describes this situation?

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Variance is the difference between the amount expected to be paid and what is actually paid. It covers both directions of deviation, so it includes situations where the payment is higher than expected and where it is lower. In hospital billing, you compare the payer’s payment to the contractually allowed amount or expected reimbursement, and any delta you observe is called a variance. An overpayment or an underpayment describes the direction of that delta, but they are just specific cases of the broader idea. An adjustment, on the other hand, is a corrective entry made to reflect changes or corrections on the account, not the difference itself between expected and actual payment.