Thea Lindgren

CLM-2024-8658, Medicaid, Hysterectomy (58150)

In reviewWith you Denied claims

Billed

$16,200

denied Mar 18

Denial risk

33%

good odds

Appeal window

lapsed

closes Apr 18

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Entered by hand
Mar 18
Denied by Medicaid
Not Covered (96)
Mar 18
Heron scored it: 33% denial risk
3 factors found, appeal path chosen
Mar 18
Appeal window lapsed
134 days ago
Apr 18

The denial

Not Covered, code 96

Patient: Thea Lindgren, born 1981-12-15
Payer: Medicaid
Procedure: Hysterectomy (58150)
Diagnosis: N80.0
Denied on: Mar 18, 2026
Assigned to: Heron

Heron says

Medicaid coverage varies by state, verify procedure is covered under patient's plan. If covered, resubmit with prior authorization and clinical documentation. Low complexity, likely a coverage verification issue.

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What I sent

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Everything I know about Thea

across every queue

Everything for this patient

Open exposure

$16,200

Recovered

1 denied claim0 prior auths0 underpayments0 backlog claims