Desmond Achebe

CLM-2026-9049, Medicare, Echocardiography, Complete (93306)

In appealWith the payer Denied claims

Billed

$2,771

denied Jul 11

Denial risk

50%

good odds

Appeal window

40d

closes Oct 9

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Jul 11
Denied by Medicare
Not Covered (96)
Jul 11
Heron scored it: 50% denial risk
3 factors found, appeal path chosen
Jul 11

The denial

Not Covered, code 96

Patient: Desmond Achebe, born 1960-06-23
Payer: Medicare
Procedure: Echocardiography, Complete (93306)
Diagnosis: I50.9
Denied on: Jul 11, 2026
Assigned to: Heron

Heron says

Service is excluded under the member's current Medicare benefit plan. Verify benefits as of the date of service, plan may have changed mid-year. If non-covered is confirmed, route to patient responsibility rather than appeal.

No appeal yet

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What I sent

Nothing sent yet.

Everything I know about Desmond

across every queue

Everything for this patient

Open exposure

$16,910

Recovered

$16,885

9 denied claims1 prior auth5 underpayments3 backlog claims

CLM-2026-7007

97530 · underpaid 8.5%

96413 · Chemotherapy Infusion, 1st Hour

93000 · Medical Necessity

97530 · underpaid 21.7%

96413 · 13d outstanding

97530 · Pre-Auth Missing

93306 · underpaid 31.4%

97530 · 72d outstanding

73630 · 134d outstanding

73630 · Missing Information

97530 · Bundling/Coding Error

96417 · Bundling/Coding Error

97110 · Coverage Terminated

73630 · Medical Necessity

93000 · underpaid 27.3%

97110 · Medical Necessity

97110 · underpaid 27.9%

$159 short

Recovered

Nov 1