Grace Mbeki

CLM-2026-9027, Aetna, Chemotherapy, Additional Sequential (96417)

In reviewWith you Denied claims

Billed

$10,197

denied Jun 24

Denial risk

39%

good odds

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 Aetna
Missing Information (16)
Jun 24
Heron scored it: 39% denial risk
3 factors found, appeal path chosen
Jun 24
Appeal window closes
23 days left to file
Sep 22

The denial

Missing Information, code 16

Patient: Grace Mbeki, born 1980-03-25
Payer: Aetna
Procedure: Chemotherapy, Additional Sequential (96417)
Diagnosis: C18.9
Denied on: Jun 24, 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 (INS882355) should be revalidated against the payer's eligibility response. Corrected claims for this reason typically pay within 17 days.