Jasper Kane

CLM-2024-8725, BCBS, Brain MRI with Contrast (70553)

In reviewWith you Denied claims

Billed

$5,200

denied Mar 15

Denial risk

38%

good odds

Appeal window

lapsed

closes Apr 15

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Imported from a CSV export
Mar 15
Denied by BCBS
Not Covered (96)
Mar 15
Heron scored it: 38% denial risk
3 factors found, appeal path chosen
Mar 15
Appeal window lapsed
137 days ago
Apr 15

The denial

Not Covered, code 96

Patient: Jasper Kane, born 1990-02-14
Payer: BCBS
Procedure: Brain MRI with Contrast (70553)
Diagnosis: G43.909
Denied on: Mar 15, 2026
Assigned to: Heron

Heron says

BCBS requires radiologist order note for MRI with contrast studies. 50% of similar claims required peer-to-peer review before approval. Attach ordering physician attestation to reduce review probability.

No appeal yet

I can draft one from this claim's history

Draft it View the claim form

Open Intelligence, pick this claim, and I write the letter from the denial, the payer's rules and the clinical guideline. You sign it here.

What I sent

Nothing sent yet.

Everything I know about Jasper

across every queue

Everything for this patient

Open exposure

$5,200

Recovered

1 denied claim1 prior auth0 underpayments0 backlog claims