Claim CLM-2024-8598
Patient
- Name
- Eleanor Hughes
- Date of birth
- 1992-05-14
- Patient id
- H028
Payer
- Name
- BCBS
- Payer id code
- 00210
Provider
- Name
- Northside Medical
- NPI
- 1982744321
Service
- Date of service
- Apr 20 (denial date, no service date on file)
- Procedure
- 29881, Knee Arthroscopy
- Diagnosis code
- M23.61
- Billed amount
- $11,500
Denial
- Reason
- Timely Filing, code 29
- Date
- Apr 20
Appeal
- Status
- No appeal filed yet
Prepared by Heron on Aug 30.