Heron

Priya Raman

CLM-2026-9145, Medicare, Chemotherapy, Additional Sequential (96417)

Written offWith me Denied claims
Billed
$2,668
denied Jan 11
Denial risk
91%
a hard one, worth it
Appeal window
closed
nothing left to file
Appeals
0
none filed yet

What I did

and what comes next
  1. Claim reached Heron
    Entered by hand
    Jan 11
  2. Denied by Medicare
    Timely Filing (29)
    Jan 11
  3. Heron scored it: 91% denial risk
    3 factors found, appeal path chosen
    Jan 11
  4. Heron
    Written off
    Every route exhausted
    May 1

The denial

Timely Filing, code 29

Patient
Priya Raman, born 1955-06-04
Payer
Medicare
Procedure
Chemotherapy, Additional Sequential (96417)
Diagnosis
C18.9
Denied on
Jan 11, 2026
Assigned to
Heron
Heron says
High recovery risk (91), prioritize this claim in the appeal queue. Timely filing window has lapsed for Medicare, appeal requires proof of original submission. Check clearinghouse acknowledgment records for the original 837 transmission date.

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

  • Proof of timely filing

Everything I know about Priya

across every queue
Everything for this patient
Open exposure
$30,147
Recovered
$2,537
7 denied claims2 prior auths1 underpayment4 backlog claims
AUTH-4024
96417 · Chemotherapy, Additional Sequential
52% odds
Pending
Aug 30
AUTH-4005
96417 · Chemotherapy, Additional Sequential
90% odds
Pending
Aug 27
CLM-2026-5093
97530 · 6d outstanding
$354
Pending payer
Aug 24
CLM-2026-9016
96417 · Missing Information
$10,427
In review
Aug 22
CLM-2026-5068
97110 · 8d outstanding
$422
Awaiting info
Aug 22
CLM-2026-9151
96417 · Bundling/Coding Error
$2,743
In review
Aug 16
CLM-2026-7014
93000 · underpaid 13.9%
$165 short
Disputed
Aug 12
CLM-2026-9001
96417 · Pre-Auth Missing
$1,826
Denied
Jul 14
CLM-2026-5120
97530 · 123d outstanding
$1,111
In follow up
Apr 29
CLM-2026-5144
96417 · 158d outstanding
$10,896
In follow up
Mar 25
CLM-2026-9136
96415 · Pre-Auth Missing
$2,203
In appeal
Feb 24
CLM-2026-9145viewing
96417 · Timely Filing
$2,668
Written off
Jan 11
CLM-2025-9112
96415 · Medical Necessity
$1,275
Recovered
Dec 13
CLM-2025-9117
97110 · Medical Necessity
$1,262
Recovered
Nov 26