Nia Okafor

CLM-2026-9057, Aetna, X-Ray Lumbar Spine, 4+ Views (72110)

RecoveredWith me Denied claims

Billed

$447

denied Feb 16

Denial risk

87%

a hard one, worth it

Appeal window

closed

nothing left to file

Recovered

$447

the money is back

What I did

and what comes next

Claim reached Heron
Entered by hand
Feb 16
Denied by Aetna
Timely Filing (29)
Feb 16
Heron scored it: 87% denial risk
3 factors found, appeal path chosen
Feb 16
Paid in full
The money is back
May 29

The denial

Timely Filing, code 29

Patient: Nia Okafor, born 1994-02-22
Payer: Aetna
Procedure: X-Ray Lumbar Spine, 4+ Views (72110)
Diagnosis: M54.51
Denied on: Feb 16, 2026
Assigned to: Heron

Appeal successful, payment posted

Heron says

High recovery risk (87), prioritize this claim in the appeal queue. Timely filing window has lapsed for Aetna, appeal requires proof of original submission. Check clearinghouse acknowledgment records for the original 837 transmission date.

No appeal yet

I can draft one from this claim's history

View the claim form

This claim is settled, so there is nothing left to write.

What I sent

Proof of timely filing

Everything I know about Nia

across every queue

Everything for this patient

Open exposure

$11,019

Recovered

$10,386

6 denied claims2 prior auths2 underpayments3 backlog claims

CLM-2026-5097

96417 · 4d outstanding

96415 · Chemotherapy Infusion, Addl Hour

73630 · 17d outstanding

97530 · Medical Necessity

93000 · underpaid 15.7%

96413 · Chemotherapy Infusion, 1st Hour

97110 · Pre-Auth Missing

93306 · 135d outstanding

96415 · underpaid 7.7%

72110 · Timely Filing

96415 · Pre-Auth Missing

97530 · Bundling/Coding Error

96413 · Medical Necessity

$9,718

Recovered

Nov 19