Heron

Liam Brennan

CLM-2024-8710, UnitedHealthcare, Coronary Angioplasty (92920)

In appealWith the payer Denied claims
Billed
$48,000
denied Mar 10
Denial risk
62%
winnable with the right notes
Appeal window
lapsed
closes May 10
Appeals
1
submitted

What I did

and what comes next
  1. Claim reached Heron
    Posted from the 835 remittance
    Mar 10
  2. Denied by UnitedHealthcare
    Medical Necessity (50)
    Mar 10
  3. Heron scored it: 62% denial risk
    3 factors found, appeal path chosen
    Mar 10
  4. Heron
    Appeal filed
    Tracking APP-2024-1055
    Mar 15
  5. Waiting on UnitedHealthcare
    Heron follows up every 14 days until they answer
    soon

The denial

Medical Necessity, code 50

Patient
Liam Brennan, born 1962-07-07
Payer
UnitedHealthcare
Procedure
Coronary Angioplasty (92920)
Diagnosis
I25.10
Denied on
Mar 10, 2026
Assigned to
Heron
Heron says
UHC requires documented failure of medical management before interventional cardiology. Include cardiac catheterization results and medication history in appeal. Peer-to-peer review with UHC medical director recommended.

The appeal

Filed Mar 15, submitted

Draft itView the claim form

Filed under tracking APP-2024-1055. I follow up with UnitedHealthcare every 14 days until they answer, and the letter will sit here once it is on file.

What I sent

  • Clinical notesMar 15
  • Operative reportMar 15

Everything I know about Liam

across every queue
Everything for this patient
Open exposure
$48,000
Recovered
$0
1 denied claim0 prior auths0 underpayments0 backlog claims
CLM-2024-8710viewing
92920 ยท Medical Necessity
$48,000
In appeal
Mar 10