Heron

Camila Souza

CLM-2024-8612, Medicare, Cardiac Stress Test (93015)

DeniedWith me Denied claims
Billed
$2,400
denied Apr 14
Denial risk
25%
good odds
Appeal window
lapsed
closes Aug 12
Appeals
0
none filed yet

What I did

and what comes next
  1. Claim reached Heron
    Posted from the 835 remittance
    Apr 14
  2. Denied by Medicare
    Duplicate Claim (18)
    Apr 14
  3. Heron
    Heron scored it: 25% denial risk
    3 factors found, appeal path chosen
    Apr 14
  4. Appeal window lapsed
    18 days ago
    Aug 12

The denial

Duplicate Claim, code 18

Patient
Camila Souza, born 1960-10-09
Payer
Medicare
Procedure
Cardiac Stress Test (93015)
Diagnosis
I25.10
Denied on
Apr 14, 2026
Assigned to
Heron
Heron says
Medicare flagged as duplicate, check for same-day claim submissions. Low risk, likely a claims processing system error. Resubmit with corrected claim frequency code.

No appeal yet

I can draft one from this claim's history

Draft itView 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

  • Corrected claim

Everything I know about Camila

across every queue
Everything for this patient
Open exposure
$2,400
Recovered
$0
1 denied claim1 prior auth0 underpayments0 backlog claims
AUTH-3230
92920 · Coronary Angioplasty
28% odds
Denied
Apr 26
CLM-2024-8612viewing
93015 · Duplicate Claim
$2,400
Denied
Apr 14