Heron

Wren Castillo

CLM-2026-9118, Cigna, Cardiovascular Stress Test (93015)

DeniedWith me Denied claims
Billed
$557
denied Jul 5
Denial risk
62%
winnable with the right notes
Appeal window
34d
closes Oct 3
Appeals
0
none filed yet

What I did

and what comes next
  1. Claim reached Heron
    Entered by hand
    Jul 5
  2. Denied by Cigna
    Medical Necessity (50)
    Jul 5
  3. Heron
    Heron scored it: 62% denial risk
    3 factors found, appeal path chosen
    Jul 5
  4. Appeal window closes
    34 days left to file
    Oct 3

The denial

Medical Necessity, code 50

Patient
Wren Castillo, born 1998-06-29
Payer
Cigna
Procedure
Cardiovascular Stress Test (93015)
Diagnosis
I25.10
Denied on
Jul 5, 2026
Assigned to
Heron
Heron says
Cigna denies 54% of 93015 claims without documented conservative treatment. Clinical notes supporting medical necessity were not attached to the original submission. Attach treatment history and imaging before appealing, overturn rate rises sharply with documentation.

No appeal yet

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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

  • Clinical notes
  • Operative report

Everything I know about Wren

across every queue