Teodora Petrova

CLM-2026-9153, BCBS, Therapeutic Activities, 15 min (97530)

DeniedWith me Denied claims

Billed

$1,236

denied Aug 18

Denial risk

38%

good odds

Appeal window

78d

closes Nov 16

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Aug 18
Denied by BCBS
Missing Information (16)
Aug 18
Heron scored it: 38% denial risk
3 factors found, appeal path chosen
Aug 18
Appeal window closes
78 days left to file
Nov 16

The denial

Missing Information, code 16

Patient: Teodora Petrova, born 1983-03-24
Payer: BCBS
Procedure: Therapeutic Activities, 15 min (97530)
Diagnosis: M62.81
Denied on: Aug 18, 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 (INS694319) should be revalidated against the payer's eligibility response. Corrected claims for this reason typically pay within 25 days.