Jonah Weiss

CLM-2026-9154, Cigna, Chemotherapy, Additional Sequential (96417)

DeniedWith me Denied claims

Billed

$5,639

denied Aug 4

Denial risk

64%

winnable with the right notes

Appeal window

64d

closes Nov 2

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Aug 4
Denied by Cigna
Medical Necessity (50)
Aug 4
Heron scored it: 64% denial risk
3 factors found, appeal path chosen
Aug 4
Appeal window closes
64 days left to file
Nov 2

The denial

Medical Necessity, code 50

Patient: Jonah Weiss, born 2005-05-15
Payer: Cigna
Procedure: Chemotherapy, Additional Sequential (96417)
Diagnosis: C18.9
Denied on: Aug 4, 2026
Assigned to: Heron

Heron says

Cigna denies 54% of 96417 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.