Heron

Tomas Herrera

CLM-2026-9147, UnitedHealthcare, Echocardiography, Complete (93306)

DeniedWith me Denied claims
Billed
$4,292
denied Aug 22
Denial risk
41%
good odds
Appeal window
82d
closes Nov 20
Appeals
0
none filed yet

What I did

and what comes next
  1. Claim reached Heron
    Posted from the 835 remittance
    Aug 22
  2. Denied by UnitedHealthcare
    Missing Information (16)
    Aug 22
  3. Heron
    Heron scored it: 41% denial risk
    3 factors found, appeal path chosen
    Aug 22
  4. Appeal window closes
    82 days left to file
    Nov 20

The denial

Missing Information, code 16

Patient
Tomas Herrera, born 1968-02-27
Payer
UnitedHealthcare
Procedure
Echocardiography, Complete (93306)
Diagnosis
I50.9
Denied on
Aug 22, 2026
Assigned to
Heron
Heron says
Claim rejected for incomplete data, most often a missing referring provider NPI or member ID mismatch. Member ID on file (INS118070) should be revalidated against the payer's eligibility response. Corrected claims for this reason typically pay within 17 days.

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

  • Referral on file

Everything I know about Tomas

across every queue