Elliot Marchetti

CLM-2026-9022, Aetna, MRI Brain w/ and w/o Contrast (70553)

In reviewWith you Denied claims

Billed

$1,531

denied May 15

Denial risk

33%

good odds

Appeal window

lapsed

closes Aug 13

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
May 15
Denied by Aetna
Duplicate Claim (18)
May 15
Heron scored it: 33% denial risk
3 factors found, appeal path chosen
May 15
Appeal window lapsed
17 days ago
Aug 13

The denial

Duplicate Claim, code 18

Patient: Elliot Marchetti, born 1993-12-27
Payer: Aetna
Procedure: MRI Brain w/ and w/o Contrast (70553)
Diagnosis: G43.909
Denied on: May 15, 2026
Assigned to: Heron

Heron says

Flagged as a duplicate of a claim submitted for the same date of service. Review service line detail, same-day related procedures often trip duplicate logic. Resubmit with an appropriate distinct-service modifier if the services were separate.

No appeal yet

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Draft it View the claim form

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

Corrected claim

Everything I know about Elliot

across every queue

Everything for this patient

Open exposure

$44,591

Recovered

5 denied claims3 prior auths2 underpayments3 backlog claims

AUTH-4080

70553 · MRI Brain w/ and w/o Contrast

96417 · Chemotherapy, Additional Sequential

70553 · MRI Brain w/ and w/o Contrast

73721 · 11d outstanding

70553 · underpaid 33.1%

73721 · Medical Necessity

70553 · Duplicate Claim

93000 · 118d outstanding

93306 · 126d outstanding

96417 · Missing Information

70553 · underpaid 12.2%

72148 · Medical Necessity

$1,743

Written off

Jan 2