Tomas Herrera

CLM-2026-9054, UnitedHealthcare, Electrocardiogram, Complete (93000)

In appealWith the payer Denied claims

Billed

$3,180

denied Apr 19

Denial risk

36%

good odds

Appeal window

lapsed

closes Jul 18

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Entered by hand
Apr 19
Denied by UnitedHealthcare
Bundling/Coding Error (97)
Apr 19
Heron scored it: 36% denial risk
3 factors found, appeal path chosen
Apr 19

The denial

Bundling/Coding Error, code 97

Patient: Tomas Herrera, born 1968-02-27
Payer: UnitedHealthcare
Procedure: Electrocardiogram, Complete (93000)
Diagnosis: R00.2
Denied on: Apr 19, 2026
Assigned to: Heron

Heron says

UnitedHealthcare bundled this line into a primary procedure billed the same day. Modifier review recommended, most bundling denials resolve on corrected resubmission. Verify NCCI edit pairs before resubmitting to avoid a second rejection.

No appeal yet

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Draft it View the claim form

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What I sent

Corrected claim

Everything I know about Tomas

across every queue

Everything for this patient

Open exposure

$40,108

Recovered

$24,365

6 denied claims2 prior auths0 underpayments5 backlog claims

CLM-2026-5123

93000 · 3d outstanding

70553 · 3d outstanding

93000 · 4d outstanding

93306 · Missing Information

73721 · 35d outstanding

72148 · MRI Lumbar Spine w/o Contrast

72148 · 37d outstanding

96417 · Chemotherapy, Additional Sequential

96417 · Coverage Terminated

93000 · Bundling/Coding Error

72148 · Bundling/Coding Error

96417 · Medical Necessity

70553 · Bundling/Coding Error

$5,991

Recovered

Nov 25