Owen Gallagher

CLM-2026-9160, Medicare, Chest X-Ray, 2 Views (71046)

RecoveredWith me Denied claims

Billed

$1,584

denied Apr 13

Denial risk

56%

winnable with the right notes

Appeal window

closed

nothing left to file

Recovered

$1,584

the money is back

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Apr 13
Denied by Medicare
Medical Necessity (50)
Apr 13
Heron scored it: 56% denial risk
3 factors found, appeal path chosen
Apr 13
Paid in full
The money is back
Jul 2

The denial

Medical Necessity, code 50

Patient: Owen Gallagher, born 1950-01-26
Payer: Medicare
Procedure: Chest X-Ray, 2 Views (71046)
Diagnosis: R05.9
Denied on: Apr 13, 2026
Assigned to: Heron

Appeal successful, payment posted

Heron says

Medicare denies 57% of 71046 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.