Elliot Marchetti

CLM-2026-9104, Aetna, Chemotherapy, Additional Sequential (96417)

In appealWith the payer Denied claims

Billed

$20,036

denied Mar 7

Denial risk

49%

good odds

Appeal window

lapsed

closes Jun 5

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Mar 7
Denied by Aetna
Missing Information (16)
Mar 7
Heron scored it: 49% denial risk
3 factors found, appeal path chosen
Mar 7

The denial

Missing Information, code 16

Patient: Elliot Marchetti, born 1993-12-27
Payer: Aetna
Procedure: Chemotherapy, Additional Sequential (96417)
Diagnosis: C18.9
Denied on: Mar 7, 2026
Assigned to: Heron

Heron says

Claim rejected for incomplete data, most often a missing referring provider NPI or member ID mismatch. Member ID on file (INS712210) should be revalidated against the payer's eligibility response. Corrected claims for this reason typically pay within 15 days.