Heron

Marcus Oyelaran

CLM-2026-9061, UnitedHealthcare, MRI Lower Extremity Joint (73721)

RecoveredWith me Denied claims
Billed
$4,809
denied Mar 15
Denial risk
53%
good odds
Appeal window
closed
nothing left to file
Recovered
$4,809
the money is back

What I did

and what comes next
  1. Claim reached Heron
    Entered by hand
    Mar 15
  2. Denied by UnitedHealthcare
    Not Covered (96)
    Mar 15
  3. Heron scored it: 53% denial risk
    3 factors found, appeal path chosen
    Mar 15
  4. Heron
    Paid in full
    The money is back
    Jul 1

The denial

Not Covered, code 96

Patient
Marcus Oyelaran, born 1986-09-01
Payer
UnitedHealthcare
Procedure
MRI Lower Extremity Joint (73721)
Diagnosis
M23.61
Denied on
Mar 15, 2026
Assigned to
Heron

Appeal successful, payment posted

Heron says
Service is excluded under the member's current UnitedHealthcare 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

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

Nothing sent yet.

Everything I know about Marcus

across every queue
Everything for this patient
Open exposure
$18,526
Recovered
$5,769
2 denied claims2 prior auths1 underpayment4 backlog claims
AUTH-4013
96415 · Chemotherapy Infusion, Addl Hour
82% odds
Pending
Aug 28
CLM-2026-5025
93306 · 3d outstanding
$3,239
Pending payer
Aug 27
CLM-2026-9155
73721 · Medical Necessity
$4,204
Denied
Aug 23
CLM-2026-5119
93306 · 8d outstanding
$2,063
In follow up
Aug 22
AUTH-4079
73721 · MRI Lower Extremity Joint
49% odds
Approved
Aug 8
CLM-2026-5148
73721 · 76d outstanding
$2,143
Partially paid
Jun 15
CLM-2026-5156
96417 · 98d outstanding
$6,877
Awaiting info
May 24
CLM-2026-9061viewing
73721 · Not Covered
$4,809
Recovered
Mar 15
CLM-2025-7089
73721 · underpaid 29.8%
$960 short
Recovered
Dec 4