Aiko Tanaka

CLM-2026-9021, UnitedHealthcare, Manual Therapy, 15 min (97140)

DeniedWith me Denied claims

Billed

$1,545

denied Jun 24

Denial risk

73%

winnable with the right notes

Appeal window

23d

closes Sep 22

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Jun 24
Denied by UnitedHealthcare
Pre-Auth Missing (197)
Jun 24
Heron scored it: 73% denial risk
3 factors found, appeal path chosen
Jun 24
Appeal window closes
23 days left to file
Sep 22

The denial

Pre-Auth Missing, code 197

Patient: Aiko Tanaka, born 1981-01-08
Payer: UnitedHealthcare
Procedure: Manual Therapy, 15 min (97140)
Diagnosis: M54.2
Denied on: Jun 24, 2026
Assigned to: Heron

Heron says

Prior authorization was not on file at time of service, UnitedHealthcare auto-denies 97140 without it. 7 similar denials at this facility in the last 90 days for the same reason. Retro-auth may be available within 30 days of service; escalate to the payer's auth desk.