Aiko Tanaka

CLM-2025-9144, UnitedHealthcare, Electrocardiogram, Complete (93000)

In appealWith the payer Denied claims

Billed

$2,985

denied Dec 21

Denial risk

71%

winnable with the right notes

Appeal window

lapsed

closes Mar 21

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Dec 21
Denied by UnitedHealthcare
Medical Necessity (50)
Dec 21
Heron scored it: 71% denial risk
3 factors found, appeal path chosen
Dec 21

The denial

Medical Necessity, code 50

Patient: Aiko Tanaka, born 1981-01-08
Payer: UnitedHealthcare
Procedure: Electrocardiogram, Complete (93000)
Diagnosis: R00.2
Denied on: Dec 21, 2026
Assigned to: Heron

Heron says

UnitedHealthcare denies 61% of 93000 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.