Heron

Jonah Weiss

CLM-2025-9139, UnitedHealthcare, Therapeutic Exercise, 15 min (97110)

RecoveredWith me Denied claims
Billed
$1,840
denied Nov 27
Denial risk
40%
good odds
Appeal window
closed
nothing left to file
Recovered
$1,840
the money is back

What I did

and what comes next
  1. Claim reached Heron
    Posted from the 835 remittance
    Nov 27
  2. Denied by UnitedHealthcare
    Bundling/Coding Error (97)
    Nov 27
  3. Heron scored it: 40% denial risk
    3 factors found, appeal path chosen
    Nov 27
  4. Heron
    Paid in full
    The money is back
    Mar 31

The denial

Bundling/Coding Error, code 97

Patient
Jonah Weiss, born 1991-06-25
Payer
UnitedHealthcare
Procedure
Therapeutic Exercise, 15 min (97110)
Diagnosis
M25.561
Denied on
Nov 27, 2026
Assigned to
Heron

Appeal successful, payment posted

Heron says
UnitedHealthcare bundled this line into a primary procedure billed the same day. Modifier review recommended, most bundling denials resolve on corrected resubmission. Verify NCCI edit pairs before resubmitting to avoid a second rejection.

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

  • Corrected claim

Everything I know about Jonah

across every queue
Everything for this patient
Open exposure
$8,086
Recovered
$2,354
4 denied claims0 prior auths1 underpayment1 backlog claim
CLM-2026-5095
97110 · 13d outstanding
$2,552
Pending payer
Aug 17
CLM-2026-9089
97110 · Timely Filing
$1,663
Denied
Aug 8
CLM-2026-9081
97530 · Medical Necessity
$2,805
In appeal
Aug 4
CLM-2026-9060
97530 · Pre-Auth Missing
$1,066
In review
Aug 1
CLM-2025-9139viewing
97110 · Bundling/Coding Error
$1,840
Recovered
Nov 27
CLM-2025-7060
97530 · underpaid 33.9%
$514 short
Recovered
Sep 28