Heron

Hannah Kowalczyk

CLM-2025-9099, Medicare, MRI Lumbar Spine w/o Contrast (72148)

RecoveredWith me Denied claims
Billed
$2,698
denied Dec 14
Denial risk
85%
a hard one, worth it
Appeal window
closed
nothing left to file
Recovered
$2,698
the money is back

What I did

and what comes next
  1. Claim reached Heron
    Imported from a CSV export
    Dec 14
  2. Denied by Medicare
    Timely Filing (29)
    Dec 14
  3. Heron scored it: 85% denial risk
    3 factors found, appeal path chosen
    Dec 14
  4. Heron
    Paid in full
    The money is back
    Apr 12

The denial

Timely Filing, code 29

Patient
Hannah Kowalczyk, born 1955-05-10
Payer
Medicare
Procedure
MRI Lumbar Spine w/o Contrast (72148)
Diagnosis
M51.16
Denied on
Dec 14, 2026
Assigned to
Heron

Appeal successful, payment posted

Heron says
High recovery risk (85), prioritize this claim in the appeal queue. Timely filing window has lapsed for Medicare, appeal requires proof of original submission. Check clearinghouse acknowledgment records for the original 837 transmission date.

No appeal yet

I can draft one from this claim's history

View the claim form

This claim is settled, so there is nothing left to write.

What I sent

  • Proof of timely filing

Everything I know about Hannah

across every queue
Everything for this patient
Open exposure
$17,932
Recovered
$16,371
8 denied claims2 prior auths0 underpayments3 backlog claims
AUTH-4057
73721 · MRI Lower Extremity Joint
60% odds
Approved
Aug 7
AUTH-4006
70553 · MRI Brain w/ and w/o Contrast
48% odds
Expired
Jul 24
CLM-2026-9066
93000 · Timely Filing
$2,656
In appeal
Jun 19
CLM-2026-5048
73721 · 74d outstanding
$3,787
Pending payer
Jun 17
CLM-2026-5006
93306 · 134d outstanding
$1,345
Pending payer
Apr 18
CLM-2026-9072
73721 · Medical Necessity
$4,167
Recovered
Mar 18
CLM-2026-5098
93000 · 181d outstanding
$5,109
Awaiting info
Mar 2
CLM-2026-9159
72148 · Not Covered
$3,448
Recovered
Feb 25
CLM-2026-9138
73721 · Missing Information
$4,824
Written off
Jan 19
CLM-2025-9130
93306 · Medical Necessity
$4,355
Recovered
Dec 31
CLM-2025-9003
70553 · Pre-Auth Missing
$5,035
In appeal
Dec 30
CLM-2025-9075
73721 · Medical Necessity
$1,703
Recovered
Dec 25
CLM-2025-9099viewing
72148 · Timely Filing
$2,698
Recovered
Dec 14