Luis Ortega

CLM-2026-9129, Aetna, X-Ray Foot, Complete (73630)

In reviewWith you Denied claims

Billed

$2,482

denied Jul 21

Denial risk

33%

good odds

Appeal window

50d

closes Oct 19

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Jul 21
Denied by Aetna
Duplicate Claim (18)
Jul 21
Heron scored it: 33% denial risk
3 factors found, appeal path chosen
Jul 21
Appeal window closes
50 days left to file
Oct 19

The denial

Duplicate Claim, code 18

Patient: Luis Ortega, born 1991-11-04
Payer: Aetna
Procedure: X-Ray Foot, Complete (73630)
Diagnosis: M79.671
Denied on: Jul 21, 2026
Assigned to: Heron

Heron says

Flagged as a duplicate of a claim submitted for the same date of service. Review service line detail, same-day related procedures often trip duplicate logic. Resubmit with an appropriate distinct-service modifier if the services were separate.

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What I sent

Corrected claim

Everything I know about Luis

across every queue

Everything for this patient

Open exposure

$12,136

Recovered

3 denied claims1 prior auth0 underpayments3 backlog claims

AUTH-4027

96415 · Chemotherapy Infusion, Addl Hour

73630 · 3d outstanding

96415 · 4d outstanding

73630 · Duplicate Claim

73630 · 74d outstanding

93306 · Medical Necessity